Traub E, Knoche E, Dick W, Völschow E
Anaesthesist. 1977 Apr;26(4):176-83.
Apgar status and acid base balance of 206 neonates, delivered by caesarean section under general anaesthesia, were investigated in order to compare the possible effects of either thiopentone- or ketamine-induction on the postpartum adaption. Several other criteria were recorded also, for instance, a possible neonatal asphyxia, the induction-delivery-interval, the maternal age, the administration of other than anaesthetic drugs etc. There were not correlations between the Apgar status and the induction-delivery interval in either groups. The number of neonates within the 3 Apgar-classes, and the asphyxiated neonates, were equally distributed in the thiopentone- and ketamine-groups. There was no correlation between maternal ages and either the thiopentone- or ketamin-babies, but a marked correlation with the number of depressed newborns. Those neonates, who were suspected to be hypoxic before anaesthesia showed a more depressed post-partum respiration after thiopentone- than after ketamine-induction. On the other hand it seems to be that neonatal respiration and total Apgar status was more depressed if the "ketamin mothers" were treated with sedatives, hypnotics and/or analgesics before caesarean section. The blood gas values and the acid base parameters did not show a statistically significant difference between the pH of the thiopentone- and the ketamine-neonates. These differences can be explained as the combination of the nonsignificant changes in PCO2 and standard-bicarbonate values. As far as can be judged from the above mentioned criteria it may be deduced that ketamine or thiopentone can equally well be used for inducation of anaesthesia for caesarean section.
为了比较硫喷妥钠诱导和氯胺酮诱导对产后适应的可能影响,对206例在全身麻醉下剖宫产分娩的新生儿的阿氏评分和酸碱平衡进行了研究。还记录了其他几个标准,例如可能的新生儿窒息、诱导-分娩间隔、产妇年龄、麻醉药物以外的药物使用等。两组中阿氏评分与诱导-分娩间隔之间均无相关性。硫喷妥钠组和氯胺酮组中处于3个阿氏评分等级的新生儿数量以及窒息新生儿数量分布均匀。产妇年龄与硫喷妥钠组或氯胺酮组的新生儿均无相关性,但与新生儿抑郁数量有显著相关性。那些在麻醉前被怀疑缺氧的新生儿,硫喷妥钠诱导后产后呼吸比氯胺酮诱导后更受抑制。另一方面,如果“氯胺酮母亲”在剖宫产术前接受了镇静剂、催眠药和/或镇痛药治疗,新生儿呼吸和阿氏总评分似乎更受抑制。硫喷妥钠组和氯胺酮组新生儿的血气值和酸碱参数在pH值上没有显示出统计学上的显著差异。这些差异可以解释为二氧化碳分压和标准碳酸氢盐值的无显著变化的综合结果。根据上述标准判断,可推断氯胺酮或硫喷妥钠同样适用于剖宫产麻醉诱导。