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麻醉方式影响择期剖宫产新生儿的健康状况及短暂性呼吸急促的发生率。

Type of anesthesia affects neonatal wellbeing and frequency of transient tachypnea in elective cesarean sections.

作者信息

Ozden Omaygenc Derya, Dogu Tugba, Omaygenc Mehmet Onur, Ozmen Ferda, Albayrak Merih Dilan, Babur Guler Gamze, Kocer Gur Emel, Ozenc Ecder

机构信息

Department of Anesthesiology, Yedikule Pulmonary Diseases and Thoracic Surgery Research Hospital , Istanbul , Turkey .

出版信息

J Matern Fetal Neonatal Med. 2015 Mar;28(5):568-72. doi: 10.3109/14767058.2014.926328. Epub 2014 Jun 12.

Abstract

OBJECTIVE

We aimed to assess whether the type of anesthesia in cesarean section (C/S) (spinal anesthesia, SA versus general anesthesia, GA) has an effect or not on umblical vein blood gas analysis and APGAR scores of term neonates and development of transient tachypnea of the newborn (TTN).

METHODS

The data of 172 procedure (85, GA versus 87, SA) were collected retrospectively. Results of umblical vein blood gas analysis, APGAR scores at first and fifth minutes and presence of TTN from in-hospital files' of neonates were examined.

RESULTS

Neonates in the SA group had significantly higher first and fifth minute APGAR scores (8, 7 versus 9, 2, p < 0.001 and 9, 3 versus 10, 2, p = 0.017, respectively). The pH value of umblical vein samples were higher (7.30 ± 0.05 versus 7.32 ± 0.05, p = 0.029) and pO2 and SaO2 levels were significantly lower in the SA group (34.8 ± 13.8 mmHg versus 27.6 ± 14.5 mmHg; p = 0.001 and 56.6% ± 18.7 versus 49.8% ± 21.4; p = 0.029, respectively) as compared to the GA group. Thirteen neonates in the GA group (15.3%) and five in the SA group (5.7%) were diagnosed as TTN (p = 0.048).

CONCLUSION

In our study, considerable determinants of fetal wellbeing was stated to be higher in C/S performed under SA in comparison to GA. Furthermore, our findings favor SA for avoidance of TTN.

摘要

目的

我们旨在评估剖宫产(C/S)时的麻醉类型(脊髓麻醉,SA与全身麻醉,GA)是否对足月儿脐静脉血气分析、阿氏评分及新生儿暂时性呼吸急促(TTN)的发生有影响。

方法

回顾性收集172例手术(85例GA与87例SA)的数据。检查新生儿住院病历中脐静脉血气分析结果、第1分钟和第5分钟的阿氏评分以及TTN的情况。

结果

SA组新生儿第1分钟和第5分钟的阿氏评分显著更高(分别为8、7与9、2,p<0.001;9、3与10、2,p=0.017)。SA组脐静脉样本的pH值更高(7.30±0.05与7.32±0.05,p=0.029),而pO2和SaO2水平显著低于GA组(34.8±13.8mmHg与27.6±14.5mmHg;p=0.001;56.6%±18.7与49.8%±21.4;p=0.029)。GA组13例新生儿(15.3%)和SA组5例新生儿(5.7%)被诊断为TTN(p=0.048)。

结论

在我们的研究中,与GA相比,SA下进行的剖宫产中胎儿健康的重要决定因素更高。此外,我们的研究结果支持SA可避免TTN。

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