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剖宫产术中使用或不使用硬膜外芬太尼后的新生儿呼吸模式

Neonatal patterns of breathing after cesarean section with or without epidural fentanyl.

作者信息

Benlabed M, Dreizzen E, Ecoffey C, Escourrou P, Migdal M, Gaultier C

机构信息

Department of Anesthesiology, Université Paris-Sud, Clamart, France.

出版信息

Anesthesiology. 1990 Dec;73(6):1110-3. doi: 10.1097/00000542-199012000-00007.

Abstract

The pattern of breathing and lung mechanics were evaluated during the first 7 h of life in full-term healthy newborns delivered by cesarean section with bupivacaine epidural anesthesia, without (group 1) or with the addition of 100 micrograms of fentanyl (group 2). Respiration and oxyhemoglobin saturation (SpO2) were measured with calibrated inductive plethysmography and pulse oximetry, respectively, and recorded from 60-420 min following birth. Compliance of respiratory system (CRS) was measured using a multiple occlusion technique at 60 and 420 min. Pattern of breathing was compared during period I (60-240 min) and II (240-420 min) with the following results: 1) the number of apnea spells was similar in both groups during both periods; 2) in both groups, from period I to period II a significant decrease in apnea duration was observed (7.6 +/- 0.7 s-4.1 +/- 0.5 s in group 1 and 6.7 +/- 1.2 s-5.1 +/- 1.0 s in group 2, respectively (P less than 0.05); 3) respiratory rate (RR) and minute ventilation (VE) were similar in both groups during both study periods; and 4) both RR and VE significantly decreased in the two groups from period I to period II (i.e., 59 +/- 5-46 +/- 2 breath per min-1 and 313 +/- 60-248 +/- 24 ml.kg-1.min-1 in group 1, and 60 +/- 2-51 +/- 1 breath.min-1 and 318 +/- 12-290 +/- 12 ml.kg-1.min-1 in group 2, respectively; P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对剖宫产并采用布比卡因硬膜外麻醉的足月健康新生儿出生后最初7小时的呼吸模式和肺力学进行了评估,分为两组:未加用(第1组)或加用100微克芬太尼(第2组)。分别采用校准后的感应式体积描记法和脉搏血氧饱和度测定法测量呼吸和氧合血红蛋白饱和度(SpO2),并在出生后60至420分钟记录。在60和420分钟时使用多次阻断技术测量呼吸系统顺应性(CRS)。比较了第一阶段(60 - 240分钟)和第二阶段(240 - 420分钟)的呼吸模式,结果如下:1)两个阶段两组的呼吸暂停发作次数相似;2)两组中,从第一阶段到第二阶段,呼吸暂停持续时间均显著减少(第1组分别为7.6±0.7秒 - 4.1±0.5秒,第2组为6.7±1.2秒 - 5.1±1.0秒,P<0.05);3)两个研究阶段两组的呼吸频率(RR)和分钟通气量(VE)相似;4)两组中RR和VE从第一阶段到第二阶段均显著降低(即第1组分别为59±5 - 46±2次/分钟和313±60 - 248±24毫升·千克⁻¹·分钟⁻¹,第2组为60±2 - 51±1次/分钟和318±12 - 290±12毫升·千克⁻¹·分钟⁻¹,P<0.05)。(摘要截断于250字)

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