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首页> 外文期刊>Canadian journal of anesthesia: Journal canadien d'anesthesie >Effects on the fetus and newborn of maternal analgesia and anesthesia: a review: (Les effets de l'analgesie et de l'anesthesie de la mere sur le foetus et le nouveau-ne: une revue).
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Effects on the fetus and newborn of maternal analgesia and anesthesia: a review: (Les effets de l'analgesie et de l'anesthesie de la mere sur le foetus et le nouveau-ne: une revue).

机译：母体镇痛和麻醉对胎儿和新生儿的影响：综述：综述。

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PURPOSE: To review the effects of maternal anesthesia and analgesia on the fetus and newborn. METHODS: An on-line computerized search of Medline, Embase, and the Cochrane Collaboration via PubMed was conducted. English language articles were selected. The bibliographies of relevant articles and additional material from other published sources were retrieved and reviewed. Principal findings: No one test clearly separates the effects on the fetusewborn, if any, of maternally administered medication during labour and delivery, or during surgery for non-obstetric indications. Supposition in this regard is limited in part by methodology previously used to study the transplacental passage of various drugs. This work needs to be repeated using a human model. Routine maternal supplemental oxygen administration is being questioned in light of research showing that free radical generation and oxidative stress are implicated as the underlying mechanisms in several neonatal conditions. Maternal hypotension is associated with neonatal acidemia and base excess correlates with neonatal outcome. Common postpartum analgesics transfer minimally into breast milk. Maternal or fetal surgery conducted during pregnancy necessitates modification of both anesthetic and surgical approaches. The key to resuscitation of the fetus is resuscitation of the mother: intra-uterine maneuvers, including perimortem Cesarean section, aim to reverse treatable causes of fetal asphyxia, restore fetal oxygenation, and correct fetal acidosis. CONCLUSIONS: The well-being of the infant is a major criterion for evaluating the anesthetic management of pregnant women. Many tools exist to assist with this determination for the fetus, whereas few are available to evaluate the newborn.
机译：目的：回顾母亲麻醉和镇痛对胎儿和新生儿的影响。方法：通过PubMed对Medline，Embase和Cochrane协作进行在线计算机搜索。选择了英语文章。检索并审查了相关文章的书目和其他已出版来源的其他材料。主要发现：在分娩，分娩或非产科适应症的手术过程中，没有一项测试能明确区分母体药物对胎儿/新生儿的影响。在这方面的假设部分地受到先前用于研究各种药物经胎盘通过的方法的限制。需要使用人类模型来重复这项工作。鉴于研究表明，自由基的产生和氧化应激与几种新生儿疾病的潜在机制有关，因此对常规的孕妇补充氧气的使用提出了质疑。产妇低血压与新生儿酸血症有关，而碱过多与新生儿结局相关。普通的产后止痛药很少转移到母乳中。在怀孕期间进行的母体或胎儿手术需要对麻醉和手术方法进行修改。胎儿复苏的关键是母亲的复苏：包括剖宫产剖宫产术在内的子宫内手术，旨在扭转可导致胎儿窒息的可治疗原因，恢复胎儿的氧合作用，并纠正胎儿酸中毒。结论：婴儿的健康状况是评估孕妇麻醉管理的主要标准。有许多工具可以帮助确定胎儿，而很少有工具可以评估新生儿。

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