两种麻醉方式对剖宫产手术娩出新生儿安全性的影响

Effects of different anesthesia on safety of cesarean newborns

目的:探讨全身麻醉对剖宫产手术娩出新生儿的影响,寻求不适于椎管麻醉产妇的最佳麻醉方式。方法:选择2008年2月至2013年6月在我院行剖宫产手术的92例产妇作为研究对象,按照麻醉方式不同分为观察组和对照组,每组46例。观察组用全身麻醉,对照组用硬膜外阻滞麻醉;比较两组产妇手术时间,两组新生儿1、5 min Apgar评分,两组新生儿出生后30 min动脉血气分析指标及出生后1、3、5 d神经行为评分。结果:观察组手术时间(36.5±6.7)min,对照组手术时间(38.4±7.2)min,两组比较差异无统计学意义(P>0.05)。两组新生儿出生后1、5 min Apgar评分均在正常范围,组间比较差异均无统计学意义(均P>0.05)。两组新生儿出生后30 min动脉血气分析各项指标均在正常范围,组间比较差异无统计学意义(P>0.05)。两组新生儿出生后1、3、5 d神经行为评分逐渐增加,各时间点组间比较差异无统计学意义(P>0.05)。结论:全身麻醉和椎管麻醉均适用于剖宫产手术。全身麻醉不会对新生儿的安全产生影响,可用于不适用椎管内麻醉的产妇。

Objective： To investigate the effects of general anesthesia on the safety of cesarean newborns and to seek optimal anesthesia for those parturients who were not suitable for spinal anesthesia. Methods： 92 parturients who underwent cesarean operation in our hospital from February,2008 to June,2013 were included in this study,and they were divided into the observation group and the control group according to the anesthesia,46 cases were in each group. The patients in the observation group were used with general anesthesia,and the patients in the control group were treated with epidural block anesthesia. The operation time and apgar scores of newborns of the two groups at 1 min,5 min were compared,and arterial blood gas indexes of newborn after 30 min after the birth and neurological behavior scores at 1 d,3 d,5 d were analyzed. Results： The operation time of the observation group and the control group were（36. 5 ± 6. 7） min and（38. 4 ± 7. 2） min,there was no significant difference between the two groups（P 〉 0. 05）. Apgar scores at 1 min,5 min after the birth were in the normal range,there was no significant difference between the two groups（P 〉 0. 05）. The arterial blood gas analysis indexes at 30 min after the birth were in the normal range,the difference was not significant（ P 〉 0. 05）. The neurobehavioral scores of the newborns increased gradually at 1 d,3 d,5 d after the birth,the difference was not significant at each time point（P 〉 0. 05）. Conclusion： General anesthesia and spinal anesthesia are suitable for cesarean section. General anesthesia has not an effect on the safety of newborns,and is a safe choice for parturients if spinal anesthesia is not suitable.