بررسی میزان سردرد، لرز و تهوع- استفراغ در بیماران مبتلا به کم‌کاری تیروئید تحت عمل جراحی سزارین با بی‌حسی نخاعی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استادیار گروه داخلی، مرکز تحقیقات بیماری‌های غیر واگیر، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

2 استادیار گروه زنان و مامایی، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

3 دانشیار گروه بیهوشی، مرکز تحقیقات بیهوشی و کنترل درد، دانشکده پزشکی، دانشگاه علوم پزشکی جهرم، جهرم، ایران.

10.22038/ijogi.2024.79428.6069

چکیده

مقدمه: کم­کاری تیروئید به‌عنوان بیماری بسیار شایعی در زنان باردار، ممکن است روند سزارین مادران باردار را تحت تأثیر قرار دهد. با توجه به اینکه بی­حسی نخاعی، گزینه مناسب‌تری برای زنان باردار مبتلا به کم­کاری تیروئید می‌باشد، لذا مطالعه حاضر با هدف بررسی عوارض بی‌حسی نخاعی در بیماران مبتلا به کم‌کاری تیروئید تحت بی‌حسی نخاعی برای سزارین انجام شد.
روش‌کار: این مطالعه موردی-شاهدی در سال 1401-1400 بر روی 83 نفر از بیمارانی که جهت سزارین به بیمارستان مطهری شهرستان جهرم مراجعه نمودند، در دو گروه کم‌کاری تیروئید (42 نفر) و شاهد (41 نفر) انجام شد. میزان سردرد، لرز، تهوع و استفراغ، درد و درد پشت در زمان‌های مختلف حین و پس از عمل اندازه‌گیری و ثبت شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 21) و آزمون­های تی تست، کای اسکوئر و من‌ویتنی انجام شد. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته­ ها: در زمان‌های 15، 30، 45، 60 دقیقه بعد از شروع عمل و در زمان ورود به ریکاوری و خارج از ریکاوری، فراوانی سردرد در بیماران گروه شاهد کمتر از گروه مورد بود، اما تفاوت معنی‌داری بین آنها وجود نداشت (05/0<p). در زمان­ های 15 دقیقه بعد از عمل و در زمان ورود به ریکاوری، فراوانی لرز در بیماران گروه شاهد به‌طور معنی‌داری کمتر از گروه مورد بود (05/0>p). در زمان­ های 30 دقیقه بعد از شروع عمل، فراوانی تهوع و استفراغ در بیماران گروه شاهد به طور معنی‌داری بیشتر از گروه مورد بود (05/0>p).
نتیجه­ گیری: با توجه به اینکه در گروه مورد تنها در برخی دقایق جراحی با افزایش بروز لرز و تهوع - استفراغ نسبت به گروه کنترل همراه بود و در بسیاری از دقایق از نظر عوارض تفاوتی با گروه کنترل نداشت؛ بنابراین به‌نظر می‌رسد می‌توان بدون نگرانی از عوارض بیشتر، از بی ­حسی داخل نخاعی در بیماران مبتلا به کم­کاری تیروئید بهره برد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The incidence of headache, shivering and nausea-vomiting in hypothyroid patients undergoing caesarean section with spinal anesthesia

نویسندگان [English]

  • Fatemeh Eftekharian 1
  • Farideh Mogharab 2
  • Reza Sahraei 3
1 Assistant Professor, Department of Internal Medicine, Fellowship of Endocrinology and Metabolism, Non-Communicable Diseases Research Center, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
2 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
3 Associate Professor, Department of Anesthesiology, Anesthesiology and Pain Research Center, Faculty of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.
چکیده [English]

Introduction: Hypothyroidism is a common disease in pregnant women, which may affect their cesarean section process. Since spinal anesthesia is a more suitable option for pregnant women with hypothyroidism, the present study was conducted with aim to investigate the complications of spinal anesthesia in patients with hypothyroidism undergoing cesarean section with spinal anesthesia.
Methods: This case-control study was conducted in 2021-2022 on 83 patients who referred to Motahari Hospital in Jahrom, Iran for cesarean section. The patients were divided into two groups: hypothyroidism (n=42) and control (n=41). The incidence of headache, shivering, nausea, vomiting, pain, and back pain were measured and recorded at different times during and after the operation. Data were analyzed using SPSS software (version 21) and t-test, chi-square and Mann-Whitney tests. P<0.05 was considered significant.
Results: At 15, 30, 45, and 60 minutes after the start of the operation and at the time of entering and leaving the recovery room, the frequency of headache was lower in the control group than the case group, but the difference was not significant (p>0.05). At 15 minutes after the operation and at the time of entering the recovery room, the frequency of shivering was significantly lower in the control group than the case group (p<0.05). At 30 minutes after the start of the operation, the frequency of nausea and vomiting was significantly higher in the control group than the case group (p<0.05).
Conclusion: Since in the case group, only at some moments during surgery, there was an increase in shivering and nausea-vomiting compared to the control group, and at most moments, there was no significant difference in complications between the two groups, it seems that spinal anesthesia can be used without concern for more complications in patients with hypothyroidism.

کلیدواژه‌ها [English]

  • Caesarean section
  • Headache
  • Hypothyroidism
  • Nausea and vomiting
  • Shivering

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مجله زنان، مامایی و نازایی ایران
دوره 27، شماره 11
بهمن 1403
صفحه 1-12

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