Moise K J, Carpenter R J, Deter R L, Kirshon B, Diaz S F
Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030.
Am J Obstet Gynecol. 1987 Oct;157(4 Pt 1):874-9. doi: 10.1016/s0002-9378(87)80076-5.
Advances in fetal therapy have led to the utilization of such techniques as intravascular transfusion of the Rh-affected fetus, bladder shunt placement in the fetus with obstructive uropathy, and percutaneous umbilical blood sampling. Fetal movement makes these procedures technically more difficult while increasing the risk of fetal injury. However, maternal sedation rarely results in adequate suppression of fetal activity. Thus we tested the sedative effects of intramuscular d-tubocurarine (3 or 1.5 mg/kg) or pancuronium bromide (0.3 mg/kg) injected into the fetal gluteal region under ultrasound guidance in conjunction with 70 invasive in utero procedures. Short-term paralysis of the fetus was induced in all cases. No deleterious effects of this technique were noted on initial examination of the neonates. Neuromuscular blockade was found to be a very useful adjunct to both diagnostic and therapeutic procedures involving the fetus.
胎儿治疗学的进展促使人们采用了诸如对受Rh影响的胎儿进行血管内输血、为患有梗阻性尿路病的胎儿放置膀胱分流管以及经皮脐血采样等技术。胎儿活动使这些操作在技术上更加困难，同时增加了胎儿受伤的风险。然而，母体镇静很少能充分抑制胎儿活动。因此，我们在超声引导下，将肌肉注射的右旋筒箭毒碱（3或1.5毫克/千克）或溴化潘库溴铵（0.3毫克/千克）注入胎儿臀区，并结合70例侵入性宫内操作，测试了它们的镇静效果。所有病例均诱导出胎儿短期麻痹。在对新生儿的初步检查中未发现该技术有任何有害影响。发现神经肌肉阻滞对于涉及胎儿的诊断和治疗程序都是非常有用的辅助手段。
