脊髓和全身麻醉对新生儿状态的影响

E. Ivanov, D. Karadzova, S. Nikolovski, A. Sivevski, K. Curlinov, M. Zlatkova, G. Dimitrov
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引用次数: 0

摘要

摘要介绍。剖腹产手术的数量急剧增加,因此产生了研究麻醉类型对新生儿影响的想法。目的是比较在全身麻醉和脊髓麻醉下出生的新生儿的重要参数。方法。将120例需要剖宫产术的患者分为两组,每组60例,第一组采用一般麻醉,第二组采用脊髓麻醉。第一组给予丙酚(2.0 ~ 2.5 mg/kg/tt)和琥珀酸酯(1 ~ 1.5 mg/kg/tt)。芬太尼0.005 mg/kg/tt、罗库溴铵0.4 ~ 0.6 mg/kg/tt先导麻醉。O2:N2O为3:3 l/min。第二组以脊髓麻醉为主。0.5%布比卡因2-3 ml在L2-L3间脊柱应用。在新生儿第1分钟和第5分钟定义Apgar评分。新生儿的酸碱状态是通过血液中的pH值和碱过量来检测的。结果。在Apgar分娩后1分钟内,SA组出生新生儿37例(61.67%),GA组出生新生儿29例(48.33%)。SA组新生儿Apgar评分为9 ~ 10分的有11例(18.33%),GA组新生儿Apgar评分为9 ~ 10分的仅有3例(5%)。在出生后的第五分钟也有类似的比例。SA组新生儿血液Ph值和碱性过剩(BE)值明显低于GA组。Ph = 7.33 vs 7.37;BE=-4.57±1.8 vs -2.96±2.3。结论。第二组新生儿的阿普加评分明显高于第一组。新生儿相对酸中毒(低SpO2和BE)对新生儿第1分钟和第5分钟Apgar评分无影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Influence of Spinal and General Anesthesia on Newborn’s Status
Abstract Introduction. The number of caesarean sections has drastically increased and thus arose the idea to examine the effect of the type of anesthesia on the neonates. The objective was to compare vital parameters in the neonates, born under general and spinal anesthesia. Method. A total of 120 patients with need for caesarean section have been divided in two groups of 60, of which the first was lead in general and the second one in spinal anesthesia. The first one was given propophol (2.0-2.5 mg/kg/tt) and succinil colin (1-1.5 mg/kg/tt). The anesthesia was lead with fentanil 0,005 mg/kg/tt and rocuronium bromide 0.4-0.6 mg/kg/tt. O2:N2O was 3:3 l/min. The second group was lead in spinal anesthesia. 2-3 ml Bupivacain 0.5% was spinally applied between L2-L3. Apgar score was defined in the neonates in the first and fifth minutes. The acido-basic status of the neonate was examined through pH values in the blood and the base excess. Results. In the first minute after birth giving with Apgar, 8 newborns 37(61,67%) were born to the group of patients with SA and 29 (48.33%) to the group of patients with GA. In 11 (18.33%) newborns born to the patients led with SA had Apgar score of 9-10, while only 3 (5%) of the newborns born to the patients led with GA had Apgar score of 9-10. Similar ratio was noted in the fifth minute after birth. Ph of the newborns’ blood as well as the base excess (BE) demonstrated significantly lower values in the group of patients led with SA than in the group of patients led with GA. Ph = 7.33 vs 7.37; BE=-4.57±1.8 vs -2.96±2.3. Conclusion. The newborns from the second group had significantly higher Apgar scores than those in the first group. The newborns’ relative acidose (lower SpO2 and BE) did not affect the newborns’ Apgar score in the first and fifth minute.
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