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泮库溴铵对剖宫产时母体循环与代谢以及胎儿代谢和产后状况的影响(作者译)

[The effects of Pavulon (pancuronium bromide) on maternal circulation and metabolism as well as on fetal metabolism and postnatal condition at Caesarean section (author's transl)].

作者信息

Klausch B, Dauss I, Stark K H, Plesse R

出版信息

Zentralbl Gynakol. 1979;101(12):796-805.

PMID:40368
Abstract

The effects of pancuronium bromide (Pavulon) on maternal circulation and metabolism as well as on fetal metabolism and postnatal conditions were studied in 13 women in late pregnancy (between gestational weeks 33 and 40) requiring Caesarean section in general anaesthesia. A comparison with results of 50 spontaneous deliveries without analgetics was performed. The average dosage of 4 mg did not effect the maternal blood pressure, fetal muscle tonus and cardiorespiratory adaption of the newborn. According to general anaesthesia we found in acid-base status a pH decrease with respiratory acidosis in comparison with spontaneous deliveries without anaesthetics, but pH and pCO2 were normalized 30 min after delivery. On the contrary, the oxygen tension were higher as at delivery as 30 min after delivery by Caesarean section. Although 1 minute Apgar score was lower than after spontaneous delivery the heart rate and frequency of ventilation were normal in every time and in the following minutes Apgar score was 7 to 10, too. An effect of pancuronium bromide to maternal or fetal carbohydrate metabolism could not be found. The less side effects on maternal cardiovascular system and the missing influence in postnatal condition recommand pancuronium bromide as a suitable relaxant in obstetrical anaesthesia, too.

摘要

对13例妊娠晚期(孕33至40周)需行剖宫产全身麻醉的孕妇,研究了潘库溴铵(巴夫龙)对母体循环和代谢以及胎儿代谢和产后状况的影响。并与50例未使用镇痛药的自然分娩结果进行了比较。4毫克的平均剂量对母体血压、胎儿肌张力和新生儿的心肺适应能力没有影响。根据全身麻醉情况,我们发现与未使用麻醉剂的自然分娩相比,酸碱状态下pH值下降伴有呼吸性酸中毒,但分娩后30分钟pH值和pCO2恢复正常。相反,剖宫产分娩后30分钟时的氧分压高于分娩时。虽然1分钟阿氏评分低于自然分娩后,但心率和通气频率在任何时候都是正常的,且在接下来的几分钟里阿氏评分也为7至10分。未发现潘库溴铵对母体或胎儿碳水化合物代谢有影响。潘库溴铵对母体心血管系统副作用较小且对产后状况无影响,这也表明它是产科麻醉中一种合适的肌肉松弛剂。

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