Department of Family Medicine, Ankara Training and Research Hospital, Ministry of Health, Ankara, Turkey.
Acta Paediatr. 2010 Jul;99(7):993-6. doi: 10.1111/j.1651-2227.2010.01761.x. Epub 2010 Apr 26.
To investigate the effect of anaesthetic agents on transcutaneous bilirubin levels during the first 24 h in neonates delivered by caesarean section.
A total of 168 neonates delivered by caesarean section, during which sevoflurane was used for general anaesthesia (group A), bupivacaine for spinal anaesthesia (group B), levobupivacaine for epidural anaesthesia (group C) and 155 neonates delivered vaginally were included in the study. Transcutaneous bilirubin levels (TBLs) of infants were measured during the first 24 h and compared with each other.
The TBLs in neonates delivered vaginally were higher than those delivered by caesarean section, but the difference was not significant. TBLs were higher in groups A and C than in group B (p = 0.034, p = 0.011 respectively). TBLs were higher in group C than in group A, but the difference was not significant (p > 0.05). When the groups were compared with vaginal delivery group, TBLs in groups A and C were found higher (p = 0.03, p = 0.022 respectively).
The route of delivery had no effect on TBL. While bupivacaine was found to have no effect on neonatal bilirubin levels, levobupivacaine increased neonatal biluribin levels, but further studies are needed for definite results.
探讨剖宫产新生儿出生后 24 小时内不同麻醉方式对经皮胆红素水平的影响。
本研究共纳入 168 例剖宫产新生儿，其中全身麻醉采用七氟醚（A 组），蛛网膜下腔麻醉采用布比卡因（B 组），硬膜外麻醉采用左旋布比卡因（C 组），同时纳入 155 例阴道分娩新生儿。在出生后 24 小时内测量婴儿的经皮胆红素水平（TBLs），并对其进行比较。
阴道分娩新生儿的 TBLs 高于剖宫产新生儿，但差异无统计学意义。A 组和 C 组的 TBLs 均高于 B 组（p = 0.034，p = 0.011）。C 组的 TBLs 高于 A 组，但差异无统计学意义（p > 0.05）。与阴道分娩组相比，A 组和 C 组的 TBLs 均升高（p = 0.03，p = 0.022）。
分娩方式对 TBL 无影响。布比卡因对新生儿胆红素水平无影响，而左旋布比卡因升高新生儿胆红素水平，但尚需进一步研究以明确结果。
