剖宫产术中麻醉意外并发症及处置
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摘要
剖宫产手术麻醉不仅需要全面考虑妊娠妇女所出现的一系列特殊生理改变,同时也要考虑麻醉用药对胎儿的影响,所选用的麻醉方式应力求简单、安全、有效。文章就目前剖宫产手术麻醉方法的选择、常见麻醉意外并发症的预防及处置做一归纳总结,以期应用于指导临床实践,降低因剖宫产麻醉而引起的并发症发生率,保障母婴安全,达到舒适化医疗的目的。
Not only should a series of special physiological changes that occur in pregnant women be considerated,but the effects of anesthesia drugs on the fetus should also be considered,in order to conduct a simple,safe,and effective anesthesia in cesarean section surgery.This review will summarize the current selection of anesthesia approachs for cesarean section and the prevention and control of common anesthesia accidents and complications,aiming at guiding the clinical practice,reducing the risk of cesarean section anesthesia,ensuring the maternal and fetal safety and achieving comfort in diagnostic and therapeutic procedure.
Not only should a series of special physiological changes that occur in pregnant women be considerated,but the effects of anesthesia drugs on the fetus should also be considered,in order to conduct a simple,safe,and effective anesthesia in cesarean section surgery.This review will summarize the current selection of anesthesia approachs for cesarean section and the prevention and control of common anesthesia accidents and complications,aiming at guiding the clinical practice,reducing the risk of cesarean section anesthesia,ensuring the maternal and fetal safety and achieving comfort in diagnostic and therapeutic procedure.
引文
[1]王昊,张锦英.麻醉意外及并发症的理性剖析[J].医学与哲学,2017,38(12B):74-77.
[2]Bulletins-Obstetrics COP.Practice Bulletin No.177:obstetric analgesia and anesthesia[J].Obstet Gynecol,2017,129(4):e73.
[3]魏芳芳.产科手术麻醉方式的选择及进展[J].中国医药科学,2018,8(9):24-26.
[4]刘文奎.剖宫产术中舒芬太尼联合小剂量罗哌卡因蛛网膜下腔麻醉的麻醉效果及安全性分析[J].中国妇幼保健,2018,33(17):3899-3901.
[5]D'Angelo R,Smiley RM,Riley ET,et al.Serious complications related to obstetric anesthesia:the serious complication repository project of the Society for Obstetric Anesthesia and Perinatology[J].Anesthesiol,2014,120(6):1505-1512.
[6]刁敏,柳慧,林雪梅.腰硬联合麻醉用于剖宫产有效性及安全性的系统评价[J].中国循证医学杂志,2014,14(10):1218-1224.
[7]姚伟瑜,林天文,李师阳.剖宫产全身麻醉新进展[J].麻醉安全与质控,2018,2(3):169-173.
[8]谭晶.2016年ASA产科麻醉操作指南更新[EB/OL].[2016-08-21].http://m.xqnmz.com/m/article/555.
[9]廖光东,罗东,姚强.美国妇产科医师学会“2017产科镇痛和麻醉实践指南”解读[J].实用妇产科杂志,2017,8(33):586-589.
[10]马虹,王国林,王俊科,等.椎管内阻滞并发症防治专家共识(2017版)[EB/OL].[2017-12-14].http://www.csaol.cn.
[11]Duggappa DR,Lokesh M,Dixit A,et al.Perfusion index as a predictor of hypotension following spinal anaesthesia in lower segment caesarean section[J].Indian J Anaesth,2017,61(8):649-654.
[12]吴东鹏,张雁翔,夏景鸿.曲马多用于预防和治疗腰硬联合麻醉下剖宫产术术后寒颤的效果[J].华西医学,2018,25(15):68-70.(2018-10-15收稿)
[2]Bulletins-Obstetrics COP.Practice Bulletin No.177:obstetric analgesia and anesthesia[J].Obstet Gynecol,2017,129(4):e73.
[3]魏芳芳.产科手术麻醉方式的选择及进展[J].中国医药科学,2018,8(9):24-26.
[4]刘文奎.剖宫产术中舒芬太尼联合小剂量罗哌卡因蛛网膜下腔麻醉的麻醉效果及安全性分析[J].中国妇幼保健,2018,33(17):3899-3901.
[5]D'Angelo R,Smiley RM,Riley ET,et al.Serious complications related to obstetric anesthesia:the serious complication repository project of the Society for Obstetric Anesthesia and Perinatology[J].Anesthesiol,2014,120(6):1505-1512.
[6]刁敏,柳慧,林雪梅.腰硬联合麻醉用于剖宫产有效性及安全性的系统评价[J].中国循证医学杂志,2014,14(10):1218-1224.
[7]姚伟瑜,林天文,李师阳.剖宫产全身麻醉新进展[J].麻醉安全与质控,2018,2(3):169-173.
[8]谭晶.2016年ASA产科麻醉操作指南更新[EB/OL].[2016-08-21].http://m.xqnmz.com/m/article/555.
[9]廖光东,罗东,姚强.美国妇产科医师学会“2017产科镇痛和麻醉实践指南”解读[J].实用妇产科杂志,2017,8(33):586-589.
[10]马虹,王国林,王俊科,等.椎管内阻滞并发症防治专家共识(2017版)[EB/OL].[2017-12-14].http://www.csaol.cn.
[11]Duggappa DR,Lokesh M,Dixit A,et al.Perfusion index as a predictor of hypotension following spinal anaesthesia in lower segment caesarean section[J].Indian J Anaesth,2017,61(8):649-654.
[12]吴东鹏,张雁翔,夏景鸿.曲马多用于预防和治疗腰硬联合麻醉下剖宫产术术后寒颤的效果[J].华西医学,2018,25(15):68-70.(2018-10-15收稿)