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[全身麻醉下剖宫产术中胃内容物误吸综合征的发生率及并发症]

[Incidence and complications of the aspiration of gastric contents syndrome during cesarean section in general anesthesia].

作者信息

Dindelli M, La Rosa M, Rossi R, Di Nunno D, Piva L, Pagnoni B, Ferrari A

机构信息

Cattedra di Ginecologia Oncologica, Università degli Studi di Milano.

出版信息

Ann Ostet Ginecol Med Perinat. 1991 Nov-Dec;112(6):376-84.

PMID:1842166
Abstract

Maternal mortality attributed to anaesthesia, decreased in the last twenty years, has in inhalation of gastric contents one of its principal causes. Pregnant women are considered "high risk". In this retrospective investigation we studied 12,380 patients undergoing caesarean section in general anaesthesia between January 1977 and December 1991. During this period of obstetric activity the frequency of aspiration syndrome is 1:1,547 general anaesthesias (0.064%), being the 61.5% of all anaesthetic complications. In the 8 patients we had no maternal and neonatal mortality. Aspiration pneumonitis occurred in three patients. All patients were admitted at our recovery room for less than 5 days. The emergency procedure (8 cases) and a difficult tracheal intubation (4 cases) are the more important risk factors. In our clinical practice we used prevention in few cases (3.1%). Our results suggest the utility in obstetric anaesthesia of high doses of thiopental (5-6 mg/kg); these doses didn't change the principal neonatal parameters, while give in pregnant woman a light anaesthesia.

摘要

过去二十年来,因麻醉导致的孕产妇死亡率有所下降,胃内容物吸入是其主要原因之一。孕妇被视为“高危人群”。在这项回顾性研究中,我们调查了1977年1月至1991年12月期间接受全身麻醉剖宫产的12380例患者。在这段产科活动期间,误吸综合征的发生率为1:1547例全身麻醉(0.064%),占所有麻醉并发症的61.5%。在这8例患者中,没有孕产妇和新生儿死亡。3例患者发生了吸入性肺炎。所有患者在我们的恢复室住院时间均少于5天。急诊手术(8例)和困难气管插管(4例)是更重要的危险因素。在我们的临床实践中,很少有病例(3.1%)采取了预防措施。我们的结果表明,大剂量硫喷妥钠(5 - 6mg/kg)在产科麻醉中有用;这些剂量不会改变主要的新生儿参数,同时能使孕妇处于轻度麻醉状态。

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