麻醉诱导至分娩的时间延长对新生儿瑞芬太尼血药浓度无影响

以下文章来源于罂粟花 ，作者anesthGH

本文由“罂粟花”授权转载

麻醉诱导至分娩的时间延长对新生儿瑞芬太尼血药浓度无影响

贵州医科大学      麻醉与心脏电生理课题组

翻译：马艳燕

编辑：宋雨婷

审校：曹莹

1目的

瑞芬太尼联合依托咪酯和七氟醚用于剖宫产手术(CS)的全麻诱导是临床常用的麻醉诱导方法。本研究旨在评估诱导至分娩（I-D）的时间与新生儿血药浓度和麻醉之间的相关性，以及其对新生儿的影响。

2方法

将52例CS全麻产妇随机分为A组(I-D<8min)和B组(I-D≥8min)。在分娩时采集母体动脉(MA)、脐静脉(UV)和脐动脉(UA)血样，用高效液相色谱-串联质谱仪分析瑞芬太尼和依托咪酯的浓度。

3结果

两组间MA、UA和UV血液中瑞芬太尼的血药浓度差异无统计学意义（P > 0.05）。A组MA和UV血液中依托咪酯血药浓度高于B组（P <0.05），B组依托咪酯UA/UV比值高于A组（P <0.05）。Spearman秩相关检验显示，在MA、UA和UV血液中，I-D时间与瑞芬太尼血药浓度之间没有相关性（P >0.05）。MA和UV血液中依托咪酯浓度与I-D时间呈负相关（P < 0.05）。

4结论

I-D时间延长对母体或新生儿瑞芬太尼的血药浓度无显著影响。瑞芬太尼靶控输注联合依托咪酯和七氟醚用于CS全身麻醉诱导是安全的。

原始文献来源：

Cai M, Liu H, Peng Y, Miao JK, Lei XF, Yu J. Prolonged Anesthesia Induction to Delivery Time Did Not Influence Plasma Remifentanil Concentration in Neonates. Drug Des Devel Ther. 2023 May 8;17:1395-1403. doi: 10.2147/DDDT.S407602.

英文原文：

Prolonged Anesthesia Induction to Delivery Time Did Not Influence Plasma Remifentanil Concentration in Neonates

Objective: Remifentanil, in combination with etomidate and sevoflurane, is commonly used in clinics for general anesthesia induction in cesarean section (CS). This study aimed to evaluate the correlation between the induction to delivery (I-D) time and neonatal plasma drug concentration and anesthesia, as well as its effects on neonates.

Methods: Fifty-two parturients in whom general anesthesia was induced for CS were divided into group A (I-D<8 min) and group B (I-D≥8 min). Maternal arterial (MA), umbilical venous (UV), and umbilical arterial (UA) blood samples were collected at delivery to analyze the remifentanil and etomidate concentrations using liquid chromatography-tandem mass spectrometry.

Results: There were no statistically significant differences between the two groups in terms of plasma concentrations of remifentanil in the MA, UA, and UV blood (P > 0.05). The plasma concentration of etomidate in MA and UV was higher in group A than that in group B (P<0.05), whereas the UA/UV ratio of etomidate was higher in group B than that in group A (P<0.05). The Spearman rank correlation test showed no correlation between the I-D time and plasma remifentanil concentration in the MA, UA, and UV plasma (P>0.05). The concentrations of etomidate in the MA and UV were negatively correlated with the I-D time (P < 0.05).

Conclusion: Prolonged I-D time did not significantly influence the maternal or neonatal plasma concentration of remifentanil. It is safe to administer remifentanil target-controlled infusion in combination with etomidate and sevoflurane for general anesthesia induction during CS.

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校对：MiLu.米鹭