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剖宫产术使用不同麻醉剂硬膜外麻醉后新生儿神经行为反应(斯坎伦试验)的研究

[Studies on neurobehavioral response (Scanlon test) in newborns after epidural anesthesia with various anesthetic agents for cesarean section].

作者信息

Higuchi M, Takeuchi S

出版信息

Nihon Sanka Fujinka Gakkai Zasshi. 1982 Dec;34(12):2143-8.

PMID:7153593
Abstract

In order to examine the influence of larger doses of anesthetic drugs on newborns, 146 infants delivered by cesarean section with epidural anesthesia employing various anesthetic agents were assessed by Apgar score, blood gas analysis, drug concentration as well as Scanlon's examination. The following results were obtained: 1. The fetal/maternal concentration ratio for bupivacaine was lowest compared with those of lidocaine and mepivacaine. 2. There was no significant difference among the epidural anesthesia with four kinds of anesthetic agents and spinal anesthesia groups in pH, Pco2, Po2 values or Apgar scores obtained from blood from the maternal artery or the umbilical vein. 3. The groups whose mothers had received epidural block with either lidocaine or mepivacaine for cesarean section showed significantly lower scores in Scanlon test compared with the groups with bupivacaine or chloroprocaine and spinal anesthesia group. From these findings, it may be concluded that bupivacaine or chloroprocaine does offer some advantages over (three local anesthetic agents) lidocaine, mepivacaine or tetracaine to the obstetric patients who need cesarean section for delivery.

摘要

为研究大剂量麻醉药物对新生儿的影响,对146例采用不同麻醉剂行硬膜外麻醉剖宫产的婴儿进行了阿氏评分、血气分析、药物浓度及斯坎伦检查评估。结果如下:1. 布比卡因的胎儿/母体浓度比与利多卡因和甲哌卡因相比最低。2. 四种麻醉剂硬膜外麻醉组与脊麻组在母体动脉血或脐静脉血的pH、Pco2、Po2值或阿氏评分方面无显著差异。3. 母亲在剖宫产时接受利多卡因或甲哌卡因硬膜外阻滞的组在斯坎伦检查中的得分显著低于接受布比卡因或氯普鲁卡因的组及脊麻组。从这些结果可以得出结论,对于需要剖宫产分娩的产科患者,布比卡因或氯普鲁卡因相对于(三种局部麻醉剂)利多卡因、甲哌卡因或丁卡因确实具有一些优势。

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