Comparison the effect of different anesthetic techniques on neonatal plasma bilirubine levels

Background and aim: In this prospective study, we examined the influence of different anaesthesiologic techniques on neonatal jaundice.Methods: With ethics approval and written consent, the 80 (ASA 1-2 status) pregnant women (were separated into four groups equally) that who were planned for delivery with elective caesarian section under general, epidural, spinal, total intravenous anaesthesia and 20 pregnant women (ASA 1-2 status) that were planned for spontaneous vaginal delivery were included in to this prospective study. All participants were at 38-40 weeks of uncomplicated pregnancy. After 10 ml/kg crystalloid preload, one anaesthetic strategy was managed randomly and than elective caesarian section was performed. For Group GA 2 mg/kg propofol, 1 mg/kg succinylcholine were performed at induction and after intubation 1-2 % MAC sevofluorane, 0.1µg/kg/min remifentanyl were given. For TİVA group 2 mg/kg/h propofol, 1mg/kg succinylcholine were performed at induction and after intubation, 10-8-6-4 mg/ kg/h propofol, 0.1µ/kg/min remifentanyl were given. For EA group 0.5% plain bupivacaine hydrochloride was given at different doses after insertion of epidural catheter. For SA group 0.5% heavy bupivacaine hydrochloride was injected intrathecally at different doses. Postoperative analgesia was performed with tramodol. Umbilical blood gas samples were collected just after the cord was clamped. Neonatal serum bilirubin levels were determined at the ages of 24 h and 5 days in 100 infantsThe sex, weight, 1th minute and 5th minute APGAR scores, hematocrit levels and phototherapy needs of the neonates were recorded. Statistical analysis was performed by Statistical Package for Social Science (SPSS) version 13.0 for Windows. Analyses included ANOVA and Tukey post-tests (P<0.05).Result: Demographic datas were similar between groups. The 24th hour and 5th day bilirubin levels were found to be statistically different between spontaneous vaginal delivery group and other groups which were received different anaesthetic techniques. (p<0.05) The percentage of newborns who needed phototherapy did not display any statistical difference among the groups (p>0.05) but we observed the worst outcome percentages in total intravenous anaesthesia group. (Figure1)Conclusion: We suggest that if the case number would be increased the assosiation of the neonatal jaundice and anaesthetic techniques may be more predictable.