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Neonatal Patterns of Breathing after Cesarean Section with or without Epidural Fentanyl

 

作者: Malik Benlabed,   Edouardo Dreizzen,   Claude Ecoffey,   Pierre Escourrou,   Marek Migdal,   Claude Gaultier,  

 

期刊: Anesthesiology  (OVID Available online 1990)
卷期: Volume 73, issue 6  

页码: 1110-1113

 

ISSN:0003-3022

 

年代: 1990

 

出版商: OVID

 

关键词: Analgesics, opioid: fentanyl;Anesthesia obstetric;Anesthetics, local: bupivacaine;Anesthetic techniques, epidural;Ventilation: pattern of breathing; compliance;Pediatrics: newborn

 

数据来源: OVID

 

摘要:

The pattern of breathing and lung mechanics were evaluated during the first 7 h of life in full-term healthy newborns delivered by cerarean section with bupivacaine epidural anesthesia, without (group 1) or with the addition of 100 μg of fentanyl (group 2). Respiration and oxyhemoglobin saturation (Spo2) were measured with calibrated inductive plethysmography and pulse oximetry, respectively, and recorded from 60–420 min following birth. Compliance of respiratory system (CRS) was measured using a multiple occlusion technique at 60 and 420 min. Pattern of breathing was compared during period I (60–240 min) and II (240–420 min) with the following results: 1) the number of apnea spells was similar in both groups during both periods; 2) in both groups, from period I to period II a significant decrease in apnea duration was observed (7.6 ± 0.7 s–4.1 ± 0.5 s in group 1 and 6.7 ± 1.2 s–5.1 ± 1.0 s in group 2, respectively (P< 0.05); 3 respiratory rate (RR) and minute ventilation (VE) were similar in both groups during both study periods; and 4) both RR and VEsignificantly decreased in the two groups from period 1 to period II (i.e., 59 ± 5–46 ± 2 breath per min−1and 313 ± 60–248 ± 24 ml. kg−1. min−1in group 1, and 60 ± 2–51 ± 1 breath. min−1and 318 ± 12–290 ± 12 ml. kg−1. min−1in group 2, respectively;P< 0.05). For newborns without apnea breathing room air, Spo2was always greater than 95%, and the lowest Spo2after the occurrence of apnea was never less than 91%. Between both groups, CRSwere similar at 60 or 420 min but significantly Increased in each group (P< 0.05) from 60–420 min (i.e., 0.59 ± 0.19–0.72 ± 0.12 ml.kg−1.cmH2O−1in group 1 and 0.54 ± 0.12–0.67 ± 0.14 ml. kg−1. cmH2O−1in group 2, respectively). The authors concluded that in healthy newborns, no respiratory impairment occurred during the first 7 h of life after cesarean section for which epidural fentanyl had been administered to the mother.

 

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