Serum Thyroid Hormones Changes in Patients Undergoing Caesarean Section Under General or Regional Anaesthesia

Abstract

The effects of anaesthesia on serum thyroid hormones were studied in 32 pregnant young women undergoing Caesarean section at term. Eighteen patients received general anaesthesia and 14 lumbar extradural blockade. Maternal serum concentrations of thyrotrophin (TSH), thyroxine (T4), triiodothyronine (T3) and reverse triiodothyronine (rT3) were measured using radioimmunoassay at 0, delivery and 24 h. There were no significant changes in TSH in the two groups. T4 concentrations decreased significantly at 24 h in the general anaesthesia group but regional anaesthesia produced a significant decrease only at the time of delivery. T3 concentrations decreased with both techniques. Reverse T3 increased markedly with general anaesthesia only at 24 h.

Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised

“…An overall reduction in mortality was still evident after we excluded studies for which the total number of patients originally randomised was not available (0.68, 0.51 to 0.91) 26 180; original authors could not be contacted (0.69, 0.53 to 0.90) 36 38 40 82 83 86 103 115 118 131 137-144 147 150 153 155 166 171 172 179 181 185 190 ; more than 5% of all patients were lost to follow up or excluded after randomisation (0.69, 0.51 to 0.91) 3 14 32 38 57 62 71 74 75 94 108 113 114 120 129 130 140 159 164 165 171 173 181 187 ; or more than 5% of the neuraxial blockade group were excluded after randomisation (0.68, 0.51 to 0.91). 28 32 57 75 94 113 120 129 130 140 159 164 165 171 173 The reduction in mortality was also evident after exclusion of two trials that were stopped before scheduled completion (0.70, 0.53 to 0.91) and exclusion of unpublished data (0.67, 0.51 to 0.88).…”

Effect of Epidural Anesthesia and Surgery on Serum Thyroid Hormone and Cortisol Levels in the Gravid Ewe

“…The mean serum rT3 concentration was significantly elevated by 30 min follow ing the initiation of anesthesia, and remained significantly increased until 48 h, similar to serum rT3 levels shown in patients having surgery using general anesthesia [1,5]. Halevy et al [14], using regional anesthesia for cesarean section, did not demonstrate an increase in serum rT3 levels; how ever, serum cortisol levels were not measured and serum rT3 concentrations were only measured at three time periods. It is possible that the increase in the serum rT3 level occurred between the sampling periods.…”

Sevofluran, Isofluran ve Propofol’ün tiroid fonksiyonlarına etkileri

“…T3 seviyesindeki azalmanın, cerrahi bölgeden çıkan afferent nörojenik uyarıdan ve kortizolden bağımsız olarak geliştiği gösterilmiştir [14]. Biyokimyasal olarak azalmış T3 seviyesi, hormonun metabolik klerensindeki artışa ve 5'-deiodinaz enzim aktivitesindeki azalmaya bağlı olarak periferal dokularda T4'ün T3'e deiodinasyonundaki değişikliğe bağlanmıştır.…”