Department of Anesthesiology, The First People's Hospital of Jingzhou, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei, China (mainland).
Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou, Guangdong, China (mainland).
Med Sci Monit. 2019 Jul 16;25:5272-5279. doi: 10.12659/MSM.914160.
BACKGROUND The objective of this study was to analyze the effects of general anesthesia in cesarean section on the umbilical cord blood gas values and intraoperative hemodynamics of parturient women. MATERIAL AND METHODS A total of 112 parturient women who received cesarean section were eventually randomized into 2 groups, GA (general anesthesia) group (n=56), and SE (combined spinal and epidural anesthesia) group (n=56). The umbilical cord blood gas values, postpartum Apgar score, intraoperative blood loss, mean arterial pressure, heart rate, total operative time, time intervals from anesthesia to delivery and from skin incision to delivery, the incidences of adverse reactions and neonatal asphyxia, and the postoperative patient satisfaction were compared between the 2 groups. RESULTS There were no significant differences between the 2 groups in total operative time, Apgar score, neonatal asphyxia rate, umbilical arterial and venous cord blood gas values, intraoperative blood loss, and time interval from skin incision to delivery (all P˃0.05). The GA group was significantly shorter in the time interval from anesthesia to delivery than the SE group (P˂0.05). The incidences of nausea, vomiting, and chills in the GA group were significantly lower than those in the SE group (all P˂0.05). The GA group was significantly higher in postoperative patient satisfaction than the SE group (P˂0.05). CONCLUSIONS General anesthesia has little impact on the umbilical cord blood gas values and Apgar score, and ensures better hemodynamic stability in cesarean section. Moreover, general anesthesia is characterized by rapid induction and is therefore valuable for use in clinical procedures.
本研究旨在分析剖宫产术中全身麻醉对产妇脐带血血气值和术中血液动力学的影响。
共 112 例剖宫产产妇最终随机分为两组：全身麻醉（GA）组（n=56）和联合脊髓-硬膜外麻醉（SE）组（n=56）。比较两组产妇的脐带血气值、产后 Apgar 评分、术中出血量、平均动脉压、心率、总手术时间、麻醉至分娩时间、皮肤切开至分娩时间、不良反应和新生儿窒息发生率以及术后患者满意度。
两组总手术时间、Apgar 评分、新生儿窒息率、脐动脉和脐静脉血气值、术中出血量、皮肤切开至分娩时间差异均无统计学意义（均 P＞0.05）。GA 组麻醉至分娩时间明显短于 SE 组（P＜0.05）。GA 组恶心、呕吐和寒战的发生率明显低于 SE 组（均 P＜0.05）。GA 组术后患者满意度明显高于 SE 组（P＜0.05）。
全身麻醉对脐带血血气值和 Apgar 评分影响较小，能确保剖宫产术中血液动力学更稳定。此外，全身麻醉诱导迅速，因此在临床操作中具有重要价值。
