胎児の痛み:証拠の体系的な学際的レビュー
Susan J Lee1, Henry J Peter Ralston, Eleanor A Drey
1School of Medicine, Department of Anatomy, University of California, San Francisco, CA 94143-0648, USA.
JAMA
|August 25, 2005
まとめ
胎児の痛みの知覚は,まだ発達していない意識的な意識を必要とするため,第3 trimesterの前にありそうにありません. 胎児手術における現在の麻酔技術は,中絶の安全性や効果が証明されていない.
科学分野:
- 医学研究 医学研究
- 産科は産婦人科です.
- アネステシオロジー アネステシオロジー
背景:
- 提案された法律は,胎児の痛みについて女性に情報を与え,20週以上の妊娠中絶の際に胎児麻酔を提供することを義務付けています.
- そのため,胎児の痛み能力と,直接胎児麻酔の安全性/有効性の検討が必要となる.
研究 の 目的:
- 胎児の痛み知覚に関する科学的証拠を評価する.
- 安全で効果的な直接胎児麻酔または中絶のための鎮痛技術の利用性と適用性を評価する.
主な方法:
- 胎児の痛み,麻酔,鎮痛に関する英語の記事を検索するために,PubMedの体系的な文献検索.
- ヒト胎児 (妊娠30週未満) または胎児の痛み/発覚に重点を置いた研究が含まれています.
- 日付の制限なしに検索し,2005年6月6日の時点で有効です.
主要な成果:
- 痛みの知覚には意識的な意識が必要です;胎児の反射やストレス反応は痛みを確認しません.
- 痛みの認識に必要な機能的なタラモコルチカル接続は,23〜30週間に発達する.
- 胎児手術における麻酔は,痛みを軽減する以外にも目的があり,人工妊娠中絶には直接適用できない.
結論:
- 限られた証拠によると,胎児の痛みの知覚は,妊娠3ヶ月前には起こりそうにないことが示唆されています.
- 直接胎児麻酔/中絶のための鎮痛薬の有効性や安全性に関する証拠はほとんどない.
- 胎児外科における現在の麻酔術は,中絶の手続きには適用されない.
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