Onizuka S, Kawano T, Takasaki M, Sameshima H, Ikenoue T
Department of Anesthesiology, Miyazaki Medical College.
Masui. 1999 Sep;48(9):977-80.
The maternal and neonatal metabolism and acid-base balance were investigated in 20 parturients undergoing combined spinal and epidural anesthesia for cesarean delivery. Patients received intravenous infusion at a rate of either 25 ml.kg-1.h-1 of lactated (LR group, n = 10) or acetated (AR group, n = 10) Ringer's solution before anesthesia, to prevent hypotension during anesthesia. We obtained venous blood samples as follows; maternal control before anesthesia, maternal sample A after the infusion, umbilical sample B, and neonatal pedal sample C 5 h after birth, and determined lactate, pyruvate, bicarbonate, and base excess concentrations, and pH in each sample. In sample A, the lactate level was significantly higher and base excess level was significantly lower in the LR group than in the AR group. The pH of sample A and B was significantly higher in the AR group than in the LR group. However, no differences in all parameters of sample C between the two groups were observed. These results demonstrated that acetated Ringer's solution is better than lactated Ringer's solution in rapid infusion before cesarean section because of the correction of neonatal lactic acidosis.
对20例行剖宫产术并接受腰麻-硬膜外联合麻醉的产妇的母婴代谢及酸碱平衡进行了研究。患者在麻醉前以25 ml·kg-1·h-1的速率静脉输注乳酸林格氏液(LR组,n = 10)或醋酸林格氏液(AR组,n = 10),以预防麻醉期间的低血压。我们按如下方式采集静脉血样:麻醉前的产妇对照样本、输注后的产妇样本A、脐血样本B以及出生后5小时的新生儿足血样本C,并测定每个样本中的乳酸、丙酮酸、碳酸氢盐、碱剩余浓度及pH值。在样本A中,LR组的乳酸水平显著高于AR组,碱剩余水平显著低于AR组。AR组样本A和B的pH值显著高于LR组。然而,两组样本C的所有参数均未观察到差异。这些结果表明,剖宫产术前快速输注醋酸林格氏液比乳酸林格氏液更具优势,因为它可纠正新生儿酸中毒。