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[左侧卧位下择期剖宫产术全身麻醉或脊髓麻醉期间的母婴酸碱状态]

[The maternal and fetal acid-base status during general or spinal anesthesia for elective cesarean section in the left tilt position].

作者信息

Haruta M, Funato T, Shinkai T, Mashimo T, Yoshiya I

出版信息

Nihon Sanka Fujinka Gakkai Zasshi. 1983 Apr;35(4):473-80.

PMID:6854096
Abstract

Thirty one healthy parturients received spinal or general anesthesia for elective cesarean section. Maternal blood pressures, maternal and fetal acid-base values, induction to delivery intervals (I-DI) and Apgar scores were determined. On spinal anesthesia, acute hydration by 6% hydroxyethyl starch solution and intramuscular injection of ephedrine were enforced prior to the block and in the left tilt position (17 degrees) oxygen inhalation immediately after the block was begun (group OII: 16 cases). As to general anesthesia, the same left tilt position was applied before the anesthesia by thiopental-0.5% halothane with-50% nitrous oxide in oxygen (group G: 15 cases). No significant decrease in maternal blood pressure was noticed, and maternal and the fetal acid-base status and Apgar scores were excellent in both groups. A positive correlation between umbilical venous pH values and 1 or 5 minutes Apgar scores was confirmed in group OII, and a negative correlation between 1 minute Apgar scores and I-DI was noticed in group G. Fetal acid-base values were not correlated with I-DI in either group, and it was postulated that placental or fetal circulation was sufficiently maintained. Biochemical status and clinical conditions in mothers and their infants are very favorable in well-conducted general or spinal anesthesia for elective cesarean section.

摘要

31名健康产妇接受了选择性剖宫产的脊髓麻醉或全身麻醉。测定了产妇血压、产妇和胎儿的酸碱值、诱导至分娩间隔时间(I-DI)和阿氏评分。对于脊髓麻醉,在阻滞前通过6%羟乙基淀粉溶液进行急性补液,并肌肉注射麻黄碱,在开始阻滞立即采取左侧倾斜位(17度)吸氧(OII组:16例)。对于全身麻醉,在使用硫喷妥钠-0.5%氟烷-50%氧化亚氮-氧气进行麻醉前采取相同的左侧倾斜位(G组:15例)。未观察到产妇血压有显著下降,两组产妇和胎儿的酸碱状态及阿氏评分均良好。在OII组中证实脐静脉pH值与1分钟或5分钟阿氏评分呈正相关,在G组中观察到1分钟阿氏评分与I-DI呈负相关。两组中胎儿酸碱值与I-DI均无相关性,推测胎盘或胎儿循环得到了充分维持。在精心实施的选择性剖宫产全身或脊髓麻醉中,母亲及其婴儿的生化状态和临床情况非常良好。

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