Zhu Chun-Xian, Chen Hong, Huang He-Feng
Department of Anesthesia, Women's Hospital, Medical College, Zhejiang University, Hangzhou 310006, China.
Zhonghua Fu Chan Ke Za Zhi. 2005 Apr;40(4):253-5.
To determine the safety of regular doses of general anesthesia and epidural anesthesia on neonates delivered by cesarean sections.
Singleton pregnant women for whom elective cesarean sections were planned after 37 gestational weeks were allocated to general anesthesia group (platelet count < 50 x 10(9)/L) or epidural anesthesia group (platelet count > or = 50 x 10(9)/L). Arterial and venous samples were withdrawn from the doubly clamped umbilical cord segment at delivery for the pH, bicarbonate, PO2, and PCO2. All delivery times, birth weights, and Apgar scores at 1 min, 5 min were recorded.
The mean Apgar score at 1 min for the general anesthesia group was 9.5 +/- 1.1 and 9.8 +/- 0.7 for the epidural anesthesia group, without significant difference (P > 0.05). The Apgar scores at 5 min of all newborns were 10. The mean umbilical arterial and venous blood pH for the general anesthesia group were 7.31 +/- 0.06, 7.31 +/- 0.04, and 7.28 +/- 0.07, 7.32 +/- 0.05 for the epidural anesthesia group respectively. No significant difference was found between the two groups (P > 0.05).
Our prospective study suggests that mode of anesthesia does not influence significantly the outcome of newborn infants delivered by elective cesarean section. It seems that both general and epidural anesthesia can be used in elective term cesarean sections safely.
确定常规剂量全身麻醉和硬膜外麻醉对剖宫产新生儿的安全性。
计划在孕37周后行择期剖宫产的单胎孕妇被分为全身麻醉组（血小板计数<50×10⁹/L）或硬膜外麻醉组（血小板计数≥50×10⁹/L）。分娩时从双钳夹的脐带段采集动脉和静脉血样，检测pH值、碳酸氢盐、PO₂和PCO₂。记录所有分娩时间、出生体重以及1分钟和5分钟时的阿氏评分。
全身麻醉组1分钟时的平均阿氏评分为9.5±1.1，硬膜外麻醉组为9.8±0.7，差异无统计学意义（P>0.05）。所有新生儿5分钟时的阿氏评分均为10分。全身麻醉组脐动脉和脐静脉血的平均pH值分别为7.31±0.06、7.31±0.04，硬膜外麻醉组分别为7.28±0.07、7.32±0.05。两组间差异无统计学意义（P>0.05）。
我们的前瞻性研究表明，麻醉方式对择期剖宫产新生儿的结局无显著影响。似乎全身麻醉和硬膜外麻醉均可安全用于择期足月剖宫产。
