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剖宫产应选择全身麻醉还是腰段硬膜外阻滞?对胎儿心率的影响。

General anaesthesia or lumbar epidural block for caesarean section? Effects on the foetal heart rate.

作者信息

Belfrage P, Irestedt L, Raabe N, Arnér S

出版信息

Acta Anaesthesiol Scand. 1977;21(1):67-70. doi: 10.1111/j.1399-6576.1977.tb01196.x.

Abstract

Caesarean section was performed in 10 patients under general anaesthesia and in 10 other patients under epidural block. The foetal heart rate was monitored continuously during anaesthesia and operation with a scalp electrode and a cardiotocograph. There was no major difference between the two anaesthetic techniques in their effect on the foetal heart rate. The most common finding was a reduction of the beat-to-beat variation. The operative time was longer in the epidural group than in the general anaesthesia group, due to a higher frequency of Pfannenstiel incisions and repeat caesarean sections in the epidural group. Clinically, all newborns seemed to be unaffected, with normal Apgar scores. Epidural block seems to be a good alternative to general anaesthesia for caesarean section, particularly when a long operative time is expected.

摘要

10例患者在全身麻醉下进行剖宫产,另外10例患者在硬膜外阻滞下进行剖宫产。麻醉和手术期间,用头皮电极和胎心监护仪持续监测胎儿心率。两种麻醉技术对胎儿心率的影响没有显著差异。最常见的发现是逐搏变化减少。由于硬膜外组耻骨联合上横切口和再次剖宫产的频率较高,硬膜外组的手术时间比全身麻醉组更长。临床上,所有新生儿似乎均未受影响,阿氏评分正常。硬膜外阻滞似乎是剖宫产全身麻醉的一个良好替代方案,尤其是在预计手术时间较长时。

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