The effects on Apgar scores and neonatal outcomes of switching from a combination of phenylephrine and ephedrine to phenylephrine alone as a prophylactic vasopressor during spinal anesthesia for cesarean section / 대한마취과학회지
Korean Journal of Anesthesiology
; : 38-42, 2014.
Artigo
em Inglês
| WPRIM (Pacífico Ocidental)
| ID: wpr-173268
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND:
Ephedrine, unlike phenylephrine, has a dose-related propensity to depress fetal pH during spinal anesthesia during cesarean section. A low arterial umbilical cord pH has a strong association with neonatal mortality and morbidity. The purpose of this retrospective study was to investigate influences of vasopressor change on Apgar scores and adverse neonatal outcomes in cesarean section.METHODS:
In obstetric anesthesia, we changed the prophylactic vasopressor from a combination of phenylephrine and ephedrine to phenylephrine alone in 2000. We evaluated the impact of vasopressor change on Apgar scores (1 and 5 min), incidence of Apgar score < 7 (1 and 5 min), neonatal seizure, continuous positive airway pressure (CPAP), intermittent positive pressure ventilation (IPPV), intraventricular hemorrhage (IVH), periventricular leucomalacia (PVL), and hypoxic ischemic encephalopathy (HIE) in low-risk elective cesarean sections during a period when the combination of phenylephrine and ephedrine was used (2008-2009, two years) and the period of phenylephrine use alone (2011-2012, two years).RESULTS:
There were no differences in Apgar scores (1 and 5 min), the incidence of 5 min Apgar score < 7, neonatal seizure, CPAP, IPPV, IVH, PVL, and HIE between the two time periods. However, the incidence of 1 min Apgar < 7 was decreased during the period of phenylephrine use compared with the period of phenylephrine and ephedrine use (P = 0.002).CONCLUSIONS:
Conversion from a combination of phenylephrine and ephedrine to phenylephrine alone as a prophylactic anti-hypotensive drug during spinal anesthesia for cesarean section in low-risk pregnancy may be associated with a significant decrease in the incidence of 1 min Apgar < 7.
Texto completo:
Disponível
Contexto em Saúde:
ODS3 - Saúde e Bem-Estar
/
ODS3 - Meta 3.4 Reduzir as mortes prematuras devido doenças não transmissíveis
/
ODS3 - Meta 3.2 Reduzir as mortes de recém nascidos e crianças com menos de 5 anos
Problema de saúde:
Meta 3.2: Reduzir as mortes de recém nascidos e crianças com menos de 5 anos
/
Doença Cardiovascular
/
Doença Cerebrovascular
/
Epilepsia
/
Cuidados de Saúde Neonatal
/
Doenças Não Transmissíveis
Base de dados:
WPRIM (Pacífico Ocidental)
Assunto principal:
Índice de Apgar
/
Fenilefrina
/
Convulsões
/
Cordão Umbilical
/
Leucomalácia Periventricular
/
Cesárea
/
Mortalidade Infantil
/
Incidência
/
Estudos Retrospectivos
/
Ventilação com Pressão Positiva Intermitente
Tipo de estudo:
Estudo de incidência
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Feminino
/
Humanos
/
Lactente
/
Recém-Nascido
/
Gravidez
Idioma:
Inglês
Revista:
Korean Journal of Anesthesiology
Ano de publicação:
2014
Tipo de documento:
Artigo