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全身麻醉和脊髓麻醉下剖宫产术后的新生儿神经行为测试。

Neonatal neurobehavioral tests following cesarean section under general and spinal anesthesia.

作者信息

Hodgkinson R, Bhatt M, Kim S S, Grewal G, Marx G F

出版信息

Am J Obstet Gynecol. 1978 Nov 15;132(6):670-4. doi: 10.1016/0002-9378(78)90862-1.

Abstract

The Scanlon Group of Early Neonatal Neurobehavioral Tests (E.N.N.S.) was administered to 150 babies delivered by elective cesarean section. Fifty of the mothers were induced into general anesthesia with thiopental, 4 mg. per kilogram, and 50 with ketamine, 1 mg. per kilogram. Fifty mothers received spinal anesthesia with 6 to 8 mg. of tetracaine. All mothers receiving spinal anesthesia were given 100 per cent oxygen by a transparent face mask and all undergoing general anesthesia received N2O-O2 (6L:6L) until delivery of the baby. All mothers were healthy and all babies weighed 2,500 grams or more, were apparently normal, and had Apgar scores of 7 or more at one minute to 10 at five minutes. Spinal anesthesia was associated with the greatest percentage of high scores on both the first and second day for overall assessment, pinprick response, tone, rooting, sucking. Moro response, placing, alertness, and total decrement (habituation) scores. There was a statistically significant difference between all the scores for spinal compared to the other two groups. The scores were lowest following a thiopental induction and intermediate with ketamine although the difference did not reach statistical significance.

摘要

对150例择期剖宫产分娩的婴儿进行了斯坎伦早期新生儿神经行为测试(E.N.N.S.)。其中50名母亲用硫喷妥钠诱导全身麻醉,剂量为每公斤4毫克;50名母亲用氯胺酮诱导全身麻醉,剂量为每公斤1毫克。50名母亲接受了6至8毫克丁卡因的脊髓麻醉。所有接受脊髓麻醉的母亲均通过透明面罩给予100%氧气,所有接受全身麻醉的母亲在婴儿娩出前均接受N2O-O2(6L:6L)。所有母亲均健康,所有婴儿体重均在2500克或以上,外观正常,1分钟时阿氏评分7分或以上,5分钟时10分。在总体评估、针刺反应、肌张力、觅食反射、吸吮反射、莫罗反射、放置反射、警觉性和总递减(习惯化)评分方面,脊髓麻醉在第一天和第二天的高分比例最高。与其他两组相比,脊髓麻醉组的所有评分均有统计学显著差异。硫喷妥钠诱导后的评分最低,氯胺酮诱导后的评分居中,尽管差异未达到统计学显著水平。

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