Title Indikacije i komplikacije carskog reza - uloga anestezije i važnost analgezije
Title (english) Indications and complications of Cesarean section - the role of anesthesia and the importance of analgesia
Author Laura Kovač
Mentor Tomislav Meštrović (mentor)
Committee member Ivana Živoder (predsjednik povjerenstva)
Committee member Tomislav Meštrović (član povjerenstva)
Committee member Rosana Ribić (član povjerenstva)
Granter University North (University centre Varaždin) (Department of Nursing) Koprivnica
Defense date and country 2024-09-16, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Public Health and Health Care Public Health
Abstract Uvod i cilj: Žena se može poroditi prirodnim, vaginalnim putem ili pak carskim rezom. Carski se rez definira kao porođaj fetusa kroz otvoreni abdominalni rez te rez materice. Dijeli se na elektivni/planirani i hitni. Trenutno se 41. tjedan trudnoće smatra medicinskom indikacijom za indukciju, dok su također postojani dokazi povećanja rizičnost majke i djeteta nakon 39. tjedana gestacije. Porod carskim rezom najčešće se izvodi pod spinalnom ili općom anestezijom. Regionalna anestezija, to jest spinalna anestezija, smatra se sigurnim i učinkovitim izborom pri elektivnom carskom rezu. Opća anestezija izvodi se kod hitnog carskog reza prve kategorije. Adekvatna analgezija nakon poroda carskim rezom još uvijek nije dovoljno zastupljena, stoga su bolovi nakon poroda česti problem. Optimalno vrijeme oporavka je šest tjedana, dok je za prilagodbu organizma potrebno i nekoliko mjeseci. Prema istraživanjima Svjetske zdravstvene organizacije, stopa poroda carskim rezom u porastu je zadnjih nekoliko godina na svjetskoj razini. Cilj istraživanja bio je dobiti uvid u indikacije i komplikacije operativnog zahvata, u odabir optimalne vrste anestezije kao i u pravodobnu primjenu analgezije.
Metode: Istraživanje je provedeno putem izvornog anketnog upitnika u online obliku. Isti se sastoji od 26 pitanja, te se provodio u periodu od 12.3.2024. do 30.4.2024. Ukupan broj ispitanika jest 380. Uzorak čine žene koje su se porodile carskim rezom.
Rezultati: Tipična ispitanica istraživanja životne je dobi između 25 i 35 godina, živi u urbanom području te je hospitalizirana u Županijskoj bolnici Čakovec. Svaki treći porod carskim rezom bio je planirani. Svaka peta rodilja susrela se s komplikacijama poroda carskim rezom. Anestezija pri porodu carskim rezom pretežito je spinalna, a samo trajanje istog u prosjeku iznosi 60 minuta. Reakcije na anesteziju su bile prisutne u svake treće rodilje. Prosječna ocjena boli jest 7. Pretežni broj ispitanica imalo je umjerene probleme s izvođenjem svakodnevnih aktivnosti.
Rasprava/zaključak: Potrebna je priprema i edukacija rodilja od strane zdravstvenih djelatnika za brži i lakši oporavak. Nedostatak analgezije ukazuje na veću razinu boli nakon zahvata, što kasnije onemogućava izvođenje aktivnosti svakodnevnog života, kao i brigu za novorođenče. Potrebo je racionalno razmotriti indikacije te pravovremeno prepoznati komplikacije. Izbor anestezije kao i dostatna analgezija od krucijalne su važnosti.
Abstract (english) Introduction and goal: A woman can give birth naturally, vaginally or by caesarean section. Caesarean section is defined as delivery of the fetus through an open abdominal incision and uterine incision. It is divided into elective/planned and emergency caesarean section. Currently, 41 weeks of pregnancy is considered the medical indication for induction and there is also evidence that the risks to the mother and newborn increase after 39 weeks, as the pregnancy progresses. The techniques of choice for caesarean section are general and spinal anaesthesia. Regional anaesthesia, i.e. spinal anaesthesia, is safe and effective, and also considered as best choice for elective caesarean section. General anaesthesia is performed for 1. category of emergency caesarean section. Adequate analgesia after cesarean delivery is still not widely available, so postpartum pain remains a common problem. The optimal time of recovery is six weeks, while several months are needed for the body to adapt. According to a recent study by the World Health Organization, the number of caesarean sections is increasing worldwide. The aim of this research was to gain insight into the indications and complications of surgery, the selection of the most appropriate type of anesthesia and the timely application of analgesia.
Methods: Research was conducted through an online questionnaire available on social media. The questionnaire was administered to women who had undergone a caesarean section and faced the challenges that this brings. It consisted 26 questions and was conducted between 12 March 2024 and 30 April 2024. Total of 380 respondents participated.
Results: The typical respondent in this survey is between the ages of 25 and 35, lives in an urban area and is hospitalized at the District Hospital in Čakovec. One in three deliveries by caesarean section was planned, and the majority were emergency deliveries, i.e. one in five women had complications. The anaesthesia during caesarean section was mainly spinal and the operation lasted up to an hour. Reactions to anaesthesia occurred in one in three caesarean sections. The average pain score was 7. Most respondents had moderate problems with activities of daily living.
Discussion/conclusion: Preparation and education of parturients by health professionals is essential for faster and easier recovery. The absence of analgesia indicates higher pain after the procedure, which later prevents activities of daily living. It is necessary to consider the indications and recognize the complications and choose the best choice of anesthesia with sufficient analgesia.
Keywords
carski rez
indikacije
komplikacije
anestezija
analgezija
Keywords (english)
caesarean section
indications
complications
anaesthesia
analgesia
Language croatian
URN:NBN urn:nbn:hr:122:966358
Study programme Title: Nursing Study programme type: university Study level: graduate Academic / professional title: sveučilišni magistar/magistra sestrinstva (sveučilišni magistar/magistra sestrinstva)
Type of resource Text
File origin Born digital
Access conditions Open access
Terms of use
Created on 2024-10-10 14:25:20