Exploration on maternal preoperative administrative patterns of naloxone for preventing neonatal asphyxia

Objective:To observe the effect of different administrative patterns of naloxone before cesarean section among pregnant women with fetal distress on neonates,and choose a more effective administrative pattern to prevent neonatal asphyxia.Methods:A total of 499 pregnant women with fetal distress meeting surgical criteria were randomly divided into two groups: 216 patients in observation group were treated with intravenous drip of naloxone(0.1 mg/mg) at 4-6 hours before cesarean section,the treatment was repeated for 1-2 times every 0.5-1 hour;233 patients in treatment group were treated with pump injection of naloxone(8 mg) at 4-6 hours before cesarean section until delivery,the speed was 8 ml/h.Both ends of umbilical cords of neonates after birth were clipped before respiration,3 ml umbilical artery blood was Abstracted for blood gas analysis.Apgar score was conducted immediately,4 ml umbilical venous blood samples of 10 neonates whose Apgar scores were 8-10,4-7,and 0-3 were randomly collected,plasma β-EP levels were detected.Results:There was no statistically significant difference in the incidence rate of mild asphyxia at birth between the two groups(P0.05),the number of neonates with severe asphyxia in observation group was statistically significantly higher than that in treatment group(χ2=6.280,P=0.013).The symptoms of neonatal acidosis in treatment group were mild,the levels of pH value,PaCO2,PaO2,and HCO3-detected by blood gas analysis were superior to those in observation group(P0.05).There was no statistically significant difference in β-EP level in umbilical venous blood between neonates without asphyxia and neonates with mild asphyxia(P0.05),the level of β-EP in umbilical venous blood of neonates with severe asphyxia in observation group was statistically significantly higher than that in treatment group(P0.05).The level of β-EP in umbilical venous blood decreased with alleviation of degree of neonatal asphyxia.The obviously effective rate in treatment group was statistically significantly higher than that in observation group(χ2=5.402,P=0.023);there was no statistically significant difference in the effective rate between the two groups(χ2=3.789,P=0.064),the ineffective rate in observation group was statistically significantly higher than that in treatment group(χ2=6.230,P=0.018).Conclusion:Continuous pump injection of naloxone at 4-6 hours before cesarean section in pregnant women with fetal distress can more effectively prevent neonatal asphyxia compared with intravenous drip of naloxone for many times.