児血液ガスからみた帝王切開の麻酔の検討

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概要

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• In the neonates delivered by normal vaginal deliveries or caesarean section under anesthesia, the acid-base balance was studied with Astrup-micro-apparatus. Furthermore, the uterine regional blood flow was measured in nonpregnant and pregnant rabbits, using thermal flowmeters:<BR>1) Metabolic acidosis of the mother was reflected on the neonate in both groups of the normal vaginal delivery and the caesarean section.<BR>2) PO<SUB>2</SUB> of the neonate delivered by the normal vaginal delivery showed higher value compared against those of the caesarean section and this difference was significant statistically (P<0.001) .<BR>3) For anesthesia for the caesarean section:<BR>i) Those which would induce depression of blood pressure and/or peripheral vasoconstriction in the mother, such as spinal anesthesia and cyclopropane anesthesia, reduced PO<SUB>2</SUB> of the neonate.<BR>ii) In case of other inhalation anesthetics, there were not any particular relationships between the kind of anesthetics and PO<SUB>2</SUB> of the neonate, insofar as the blood pressure of the mother was maintained at the normal level; it was concluded that exchange from nitrous-oxide-oxygen mixture to pure oxygen inhalation was needless after laparotomy.<BR>4) No correlation was discernible between PO<SUB>2</SUB> of the neonate and Apgar score.<BR>5) No particular aggravation of acid-base balance was recognized in cases of the emergency caesarean section compared with the elective one.<BR>6) Bathing of the neonate after delivery improved respiration, metabolic acidosis, general condition, and peripheral circulation.<BR>7) In the rabbit, hyperventilation caused a moderate decrease of uterine blood flow.

著者

• 佐伯 志明

  昭和大学医学部麻酔学教室

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