Investigation of factors affecting cardiac parameters in patients WHO undergoing elective cesarean section

Cesarean section (C/S) is frequently applied in cases of fetal distress, dystocia, maternal diseases, bleeding, abnormal presentation, previous C/S operation, and vaginal delivery is not possible. Both the physiological changes in pregnancy and the applied anesthesia method have some effects on cardiac electrical activity and hemodynamics. In this study, we aimed to compare the cardiac effects of general, spinal, and epidural anesthesia in pregnant women who underwent cesarean section. In our study, 60 pregnant women with American Society of Anesthesiologists (ASA) physical status II, aged between 18 to 45 years, who underwent elective cesarean section were divided into 4 groups according to the anesthesia technique: Desflurane Group (Group D), Sevoflurane Group (Group G), Spinal Group (Group S), and Epidural Group (Group E). Intraoperative hemodynamic data and preoperative, intraoperative, and postoperative holter records of pregnant women were evaluated. When the mean arterial pressures of the groups were compared, there were statistically significant differences between the groups in different time periods, in addition, the values of Group S and Group E were statistically significantly lower than the Group D and Group G. Although there were statistically significant differences between the groups in the intraoperative SpO2 values of the pregnant women, no values below the normal limits were measured. In all groups, the QTc interval increased in different time periods. The highest increase was observed in the Group D and the least increase was observed in the Group E. Considering both hemodynamic stability and QTc changes, we think that epidural anesthesia may be a good choice in pregnant with risk for arrhythmia because prolongation of QTc interval can cause serious arrhythmias even in healthy people. Keywords: Sevoflurane, desflurane, spinal, epidural, QTc.