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剖宫产全身麻醉与硬膜外麻醉对新生儿神经行为反应影响的比较。

Comparison of the effects of general and epidural anaesthesia for caesarean section on the neurobehavioural responses of newborn infants.

作者信息

Kangas-Saarela T, Koivisto M, Jouppila R, Jouppila P, Hollmén A

机构信息

Department of Anaesthesiology, University of Oulu, Finland.

出版信息

Acta Anaesthesiol Scand. 1989 May;33(4):313-9. doi: 10.1111/j.1399-6576.1989.tb02915.x.

Abstract

Thirty-one neonates delivered by elective caesarean section were evaluated at the ages of 3 h, 1 day, 2 days and 4-5 days using Scanlon's Early Neonatal Neurobehavioural Scale and tests for orientation. Thirteen of the mothers received general anaesthesia and 18 epidural anaesthesia. All the mothers were healthy and not in labour. All the neonates weighed 2500 g or more and had Apgar scores of 7 or more at 1, 5 and 15 min. The neonates delivered with epidural anaesthesia scored significantly lower on rooting at the age of 3 h than those delivered with general anaesthesia, but the latter scored significantly lower on habituation to sound and orientation to both animate and inanimate visual stimuli. General anaesthesia seemed to depress the infants' interactive processes (orientation items), and their ability to make an appropriate response to repetitive stimuli (habituation) more than did epidural anaesthesia, indicating greater global depression. This depression was short-lived, however, and there were no differences between the groups on any of the parameters after 24 h.

摘要

对31例择期剖宫产分娩的新生儿,分别在出生3小时、1天、2天和4 - 5天时,使用斯坎伦早期新生儿神经行为量表及定向测试进行评估。13位母亲接受全身麻醉,18位接受硬膜外麻醉。所有母亲均健康且未临产。所有新生儿体重均在2500克及以上,出生1分钟、5分钟和15分钟时阿氏评分均在7分及以上。硬膜外麻醉下分娩的新生儿在3小时时的觅食反射得分显著低于全身麻醉下分娩的新生儿,但后者在对声音的习惯化以及对 animate 和 inanimate 视觉刺激的定向方面得分显著更低。全身麻醉似乎比硬膜外麻醉更能抑制婴儿的互动过程(定向项目)以及他们对重复刺激做出适当反应的能力(习惯化),表明全身麻醉导致的整体抑制作用更强。然而,这种抑制是短暂的,24小时后两组在任何参数上均无差异。

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