Correlation between anesthetic concentration and low Apgar scores in neonates born via Cesarean sections under general anesthesia.

IF 2 3区医学 Q2 PEDIATRICS BMC Pediatrics Pub Date : 2024-09-07 DOI:10.1186/s12887-024-05041-1

Yang Gao, Yun Song, Jingkun Miao, Xiaofeng Lei, Hao Liu, Lin Gan, Meng Cai, Jin Yu

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Abstract

Objectives: This study aimed to compare plasma concentrations of anesthetic drugs administered during Cesarean section with low Apgar score in neonates deliveried under general anesthesia and analyze associated risk factors.

Methods: Data from 76 neonates undergoing Cesarean section under general anesthesia with blood concentrations of anesthetic drugs were analyzed. A low Apgar score was defined as ≤ 7. Perioperative maternal and neonatal data were collected and analyzed. Neonates were divided into a control group (Group CON, n = 65) and a low Apgar score group (Group LAS, n = 11) based on Apgar score.

Results: There were no significant differences in the plasma concentrations of anesthetic drugs in maternal artery, umbilical vein or umbilical artery blood between the two groups. Risk factors for neonatal low Apgar scores during Cesarean section under general anesthesia were premature delivery (aOR 10.2, 95% CI = 1.8-56.9) and preoperative fetal distress (aOR 9.6, 95% CI = 1.3-69.0). The prediction model was: probability = 1/(e^‑Y), Y= -4.607 + 2.318× (premature delivery) + 2.261× (fetal distress) (yes = 1, no = 0). The Hosmer-Lemeshow test showed χ²= 9.587, P = 0.213, and the area under the curve (AUC) was 0.850 (0.670 ~ 1.000). With a cutoff value of 0.695, sensitivity and specificity were 81.8% and 87.7%, respectively.

Conclusions: There was no correlation between blood concentration of general anesthetic drugs and Apgar score or occurrence of neonatal low Apgar scores. Premature delivery and preoperative fetal distress were identified as independent risk factors for neonatal low Apgar scores after Cesarean section under general anesthesia.

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麻醉剂浓度与全身麻醉下剖腹产新生儿低阿普加评分之间的相关性。

研究目的本研究旨在比较剖宫产术中麻醉药物血浆浓度与全身麻醉下分娩的新生儿低Apgar评分，并分析相关风险因素：方法：分析了76名在全身麻醉下接受剖宫产术的新生儿的麻醉药物血药浓度数据。Apgar评分≤7分为低分。收集并分析了围手术期产妇和新生儿的数据。根据Apgar评分将新生儿分为对照组（CON组，n = 65）和低Apgar评分组（LAS组，n = 11）：结果：两组新生儿在母体动脉、脐静脉或脐动脉血中的麻醉药物血浆浓度无明显差异。全身麻醉下剖宫产术中新生儿低Apgar评分的风险因素为早产（aOR 10.2，95% CI = 1.8-56.9）和术前胎儿窘迫（aOR 9.6，95% CI = 1.3-69.0）。预测模型为：概率 = 1/（e-Y），Y= -4.607 + 2.318×（早产）+ 2.261×（胎儿窘迫）（是 = 1，否 = 0）。Hosmer-Lemeshow 检验显示，χ²= 9.587，P = 0.213，曲线下面积（AUC）为 0.850（0.670 ~ 1.000）。以 0.695 为临界值，灵敏度和特异性分别为 81.8%和 87.7%：结论：全身麻醉药物的血液浓度与 Apgar 评分或新生儿低 Apgar 评分的发生率之间没有相关性。早产和术前胎儿窘迫是全身麻醉下剖宫产术后新生儿低Apgar评分的独立危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Pediatrics PEDIATRICS-

CiteScore

3.70

自引率

4.20%

发文量

683

审稿时长

3-8 weeks

期刊介绍： BMC Pediatrics is an open access journal publishing peer-reviewed research articles in all aspects of health care in neonates, children and adolescents, as well as related molecular genetics, pathophysiology, and epidemiology.