Kulakov V I, Proshina I V, Balich E Ia, Liashko E S, Sokologorskiĭ S V
Anesteziol Reanimatol. 1992 Sep-Dec(5-6):3-5.
Sixty eight anesthesia procedures during abdominal delivery in patients with late toxemia of pregnancy have been analysed. In 32 cases the diagnosis was preeclampsia, in 8 cases--eclampsia, in 28 cases III degree nephropathy. Depending on the variant and method of anesthesia the subjects were divided into 3 clinical groups. Group I comprised 31 women to whom cesarean section was performed under general endotracheal anesthesia. In group II (24 pregnant women) analgesia was achieved by prolonged epidural anesthesia (PEA). In group III (13 patients) a combination of PEA and superficial endotracheal anesthesia was used. Analysis of the anesthesia techniques in patients with severe late toxemia of pregnancy has established that in endotracheal anesthesia it is sometimes impossible to block completely pathological and operation-induced nociceptive pulsation. PEA has a good analgetic effect but ensures no neuroautonomous protection, and upon discontinuation of action of the local anesthetic there is a danger of the onset of the convulsion syndrome and signs of preeclampsia or eclampsia. Taking into account the advantages and disadvantages of endotracheal anesthesia and PEA, a technique based on the combination of both variants has been selected, which ensures optimal anesthesiological protection in abdominal delivery.
对68例妊娠晚期中毒患者剖宫产术中的麻醉过程进行了分析。其中32例诊断为子痫前期，8例为子痫，28例为Ⅲ度肾病。根据麻醉方式和方法，将研究对象分为3个临床组。第一组包括31名妇女，她们在全身气管内麻醉下进行剖宫产。第二组（24名孕妇）通过延长硬膜外麻醉（PEA）实现镇痛。第三组（13名患者）采用PEA与表面气管内麻醉相结合的方法。对重度妊娠晚期中毒患者麻醉技术的分析表明，在气管内麻醉中，有时无法完全阻断病理性和手术引起的伤害性搏动。PEA具有良好的镇痛效果，但不能确保神经自主保护，并且在局部麻醉药作用停止后，有发生惊厥综合征以及子痫前期或子痫体征的风险。考虑到气管内麻醉和PEA的优缺点，选择了一种基于两种方式相结合的技术，该技术可确保剖宫产术中最佳的麻醉保护。
