2002 Fiscal Year Final Research Report Summary
Experimental and clinical research for effect of fetal anesthesia to neonatal stress response
| Project/Area Number |
13671869
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Pediatric surgery
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| Research Institution | Kyushu University |
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Principal Investigator |
YAMANOUCHI Takeshi Kyushu University, Faculty of medicine, Ass., 医学部付属病院, 助手 (50294921)
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| Co-Investigator(Kenkyū-buntansha) |
MASUMOTO Kouji Kyushu University, Faculty of medicine, Ass., 医学部付属病院, 助手 (20343329)
TAGUCHI Tomoaki Kyushu University, Faculty of medicine, Ass.Prof., 医学部付属病院, 助教授 (20197247)
SUITA Sachiyo Kyushu University, Faculty of medicine, Prof., 大学院・医学研究院, 教授 (30038856)
UESUGI Toru Kyushu University, Faculty of medicine, The medical stuff, 医学部付属病院, 医員
NAKAMURA Masatoshi Kyushu University, Faculty of medicine, The medical stuff, 医学部付属病院, 医員
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| Project Period (FY) |
2001 – 2002
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| Keywords | fetal anesthesia / stress response / cytokine / cortisol / congenital diaphragmatic hernia / neonatal surgery / mechanical ventilation |
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| Research Abstract |
<Experimental research>
Neonatal rats in fetal anesthesia group (group FA) received an intra-abdominal injection with morphine hydrochloride (3mg/kg) to their mothers before caesarean section. Neonatal rats in control group (group C) received no morphine hydrochloride treatment. Caesarean sections were performed under general anesthesia with ether and pentobarbital sodium in both groups. Neonatal rats were intubated and managed under mechanical ventilation for 3 hours. Blood samples and bronchoalveolar lavage fluid (BAL) were collected at birth and 3 hours after birth. Serum levels of IL-6 and IL-10 and TNF-α levels of BAL were measured by ELISA.
The levels of serum IL-6 were not different between two groups at birth (74.1 ± 19.8 pg/ml in group C vs 81.7±46.5pg/ml in group FA), however they were significantly elevated in group C 3 hours after birth than those in group FA (183.0 ± 66.5 pg/ml vs 86.4 ± 46.8pg/ml respectively). The levels of serum IL-10 were not different between two groups
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. TNF-α concentrations in BAL at birth were elevated in group C than group FA, however the difference were not significant.
<Clinical research>
Neonates in group FA were consisted of CDH patients who received fetal anesthesia by giving morphine hydrochloride (20-30mg) to their mothers before caesarean section and were repaired within 24 hours after birth. Neonates in group non-FA consisted of surgical neonates born by caesarean section without fetal anesthesia and operated within 24 hours after birth. The degree of surgical stress evaluated by Oxford Surgical Stress Scale were not different between two groups. Measured parameters were the perioperative levels of serum CRP, cortisol and IL-6.
Serum CRP levels in group non-FA reached the peak value (23.68 ± 0.84 mg/dl) on postoperative day 2, however the peak value (0.77 ± 0.21 mg/dl) in group FA was significantly lower than that in group FA. Serum cortisol levels in group non-FA reached the peak value (25.0 ± 2.5 μg/dl) just after surgery and decreased in six hours, however serum cortisol levels in group FA were not elevated during study period. The serum levels of IL-6 in group non-FA showed biphasic peaks just after operations and 12 hours after operations, however serum IL-6 levels in group FA was not elevated after operations. Stress response induced by neonatal surgery were suppressed by fetal anesthesia. Less
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