Dwyer R, Fee J P, Moore J
Department of Anaesthesia, Queens University, Belfast and Royal Maternity Hospital.
Br J Anaesth. 1995 Apr;74(4):379-83. doi: 10.1093/bja/74.4.379.
Twenty-three patients undergoing Caesarean section received either 0.5% halothane or 0.8% isoflurane to supplement nitrous oxide-oxygen anaesthesia. We studied the rate of uptake of the agents by the mother and fetus by measuring partial pressures in maternal arterial (Pa) and fetal umbilical venous (Puv) blood. Mean induction-delivery interval did not differ between the halothane (10.8 min) and isoflurane (11.7 min) groups. There were no differences in maternal heart rate, arterial pressure, pH and blood-gas tensions and fetal pH, blood-gas tensions or Apgar scores between the two groups. Isoflurane uptake by the mother was more rapid than halothane; at delivery, mean Pa of isoflurane as a fraction of the inspired partial pressure (Pl) was 0.44 compared with 0.35 for halothane (P < 0.05). Mean Puv as a fraction of maternal Pa at delivery was 0.71 for both agents; thus placental transfer was the same for both agents. Consequently mean Puv/Pl was greater for isoflurane (0.32) than halothane (0.26) (P < 0.05). We conclude that both halothane and isoflurane are suitable agents for general anaesthesia for Caesarean section. The rate of uptake of isoflurane by the mother during Caesarean section was more rapid than halothane. The rate of uptake by the fetus from the mother was the same for halothane and isoflurane, so that fetal partial pressure as a fraction of the inspired partial pressure was greater for isoflurane than halothane.
23例行剖宫产的患者接受了0.5%的氟烷或0.8%的异氟烷以补充氧化亚氮-氧气麻醉。我们通过测量母体动脉血(Pa)和胎儿脐静脉血(Puv)中的分压来研究母体和胎儿对这些药物的摄取率。氟烷组(10.8分钟)和异氟烷组(11.7分钟)之间的平均诱导-分娩间隔无差异。两组之间母体心率、动脉压、pH值和血气张力以及胎儿pH值、血气张力或阿普加评分均无差异。母体对异氟烷的摄取比氟烷更快;分娩时,异氟烷的平均Pa占吸入分压(Pl)的比例为0.44,而氟烷为0.35(P<0.05)。两种药物分娩时的平均Puv占母体Pa的比例均为0.71;因此,两种药物的胎盘转运相同。因此,异氟烷的平均Puv/Pl(0.32)高于氟烷(0.26)(P<0.05)。我们得出结论,氟烷和异氟烷都是剖宫产全身麻醉的合适药物。剖宫产期间母体对异氟烷的摄取率比氟烷更快。氟烷和异氟烷从母体到胎儿的摄取率相同,因此异氟烷的胎儿分压占吸入分压的比例高于氟烷。