Marx G F, Luykx W M, Cohen S
Br J Anaesth. 1984 Sep;56(9):1009-13. doi: 10.1093/bja/56.9.1009.
Fetal biochemical and neonatal clinical data were compiled in 126 emergency Caesarean sections performed for fetal distress. The choice of anaesthetic technique was determined by the wishes of the mother. General anaesthesia was administered to 71 parturients and regional analgesia to 55 (subarachnoid block 33, extension of extradural block 22). The aetiologies of fetal distress and the skin incision-delivery and uterine incision-delivery intervals were not significantly different between the two anaesthesia groups. Umbilical artery blood pH values were higher than the last scalp capillary blood pH values in 63% of the general anaesthesia and in 80% of the regional analgesia cases. Umbilical vein and artery blood-gas and pH data were similar in the two anaesthesia groups, but 1-min Apgar scores were significantly better following regional analgesia. Despite the presence of fetal distress, subarachnoid blockade was a most suitable method of anaesthesia in experienced hands.
对126例因胎儿窘迫而行急诊剖宫产的胎儿生化及新生儿临床数据进行了汇总。麻醉技术的选择取决于母亲的意愿。71例产妇接受全身麻醉，55例接受区域镇痛（蛛网膜下腔阻滞33例，硬膜外阻滞延长22例）。两组麻醉组胎儿窘迫的病因以及皮肤切开至分娩和子宫切开至分娩的间隔时间无显著差异。63%的全身麻醉病例和80%的区域镇痛病例中，脐动脉血pH值高于最后一次头皮毛细血管血pH值。两组麻醉组的脐静脉和动脉血气及pH数据相似，但区域镇痛后1分钟阿氏评分明显更好。尽管存在胎儿窘迫，但在经验丰富的医生手中，蛛网膜下腔阻滞是一种非常合适的麻醉方法。
