Inhalation anesthetic agents inhibit uterine muscle contractility in laboratory experiments; therefore, intravenous anesthetic use is recommended to avoid the atonic effects of inhalation anesthetics after cesarean section delivery of a fetus. However, the clinical impact of inhalation anesthetic use remains unclear. This study aimed to examine the effects of inhalation anesthetic agents used after delivery on intraoperative blood loss in cesarean section. A single-center retrospective study was performed using clinical data from patients who underwent emergency cesarean section during a 7-year period. A total of 511 patients were analyzed. General anesthesia was performed in 147 patients, and the remaining 364 patients received cesarean section under spinal anesthesia. For general anesthesia, propofol and inhalation anesthesia (sevoflurane and desflurane) were used after cesarean delivery in 125 and 22 patients, respectively. Multivariate regression analysis showed that intraoperative blood loss after delivery was comparable to propofol (−155 mL; 95%CI, −344 to 35 mL). Inhalation anesthetic agents used after delivery were not associated with increased blood loss during cesarean section. Prospective large studies are needed to support these findings. \n吸入麻酔薬は基礎研究において子宮平滑筋の弛緩作用が示されている。しかし，臨床において吸入麻酔薬の使用が子宮の弛緩におよぼす影響はほとんど分かっていない。そこで本研究では，分娩後に使用する麻酔薬と帝王切開の術中出血量との関連について検討した。当院で7 年間の観察期間に緊急帝王切開が行われた511例の症例を後方視的に解析した。全身麻酔が147例および脊椎麻酔が364例あった。全身麻酔のうち，分娩後に使用された麻酔薬はプロポフォールが125例および吸入麻酔が22例（セボフ ルラン15例，デスフルラン7 例）であった。多変量解析の結果，吸入麻酔の使用はプロポフォールの使用と比較してむしろ出血量の減少傾向を示した（−155 mL；95％信頼区間，−344～35 mL）。分娩後の吸入麻酔薬の使用と帝王切開の術中出血量との関連は認められなかった。これらの知見を支持するためにはさらなる大規模研究が必要である。

Article

Toyama medical journal, 33(1), 2023.3, pp.7-11