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剖宫产脊髓麻醉期间用于宫内复苏的手术台倾斜与骨盆倾斜位置

Table Tilt Versus Pelvic Tilt Position for Intrauterine Resuscitation during Spinal Anaesthesia for Caesarian Section.

作者信息

Haleem Shahla, Singh Neeraj K, Bhandari Shyam, Sharma Dheeraj, Amir S Hussain

机构信息

Reader, J.N. Medical College, AMU, Aligarh, India.

出版信息

J Anaesthesiol Clin Pharmacol. 2011 Jan;27(1):31-4.

Abstract

BACKGROUND

This study was undertaken to compare the effects on intrauterine resuscitation by table tilt versus pelvic tilt position after spinal anaesthesia for Caesarian Section. PATIENTS #ENTITYSTARTX00026;

METHODS

FIFTY ASA I AND II PATIENTS WHO FULFILLED THE ELIGIBILITY CRITERIA WERE ENROLLED IN THE STUDY AND WERE DIVIDED INTO TWO GROUPS: group W (Pelvic tilt with wedge under right hip and group L- (15(0)left lateral table tilt) and received spinal anaesthesia. The following parameters were recorded. Heart rate (HR), mean arterial pressure (MAP) at baseline, 2mins, 5 min and then 5 min thereafter. Mean height of block, Total no. of segments blocked, Onset Time of sensory block (in Minutes), ephedrine doses, incidence of hypotension & bradycardia, APGAR score at 1& 5 Minutes.

RESULTS

The decrease in MAP was much more in wedged position as compared to table tilt position also the incidence of hypotension was 40% in wedged position as compared to 12% in table tilt position. Mean height of block, Total no. of segments blocked, and boluses of inj. ephedrine used were more in the wedged position than in table tilt position.

CONCLUSION

Wedge placement caused increased incidence of hypotension and higher blockade after spinal anaesthesia as compared to left lateral table tilt position, there was no adverse effects on foetus and patients tolerated wedge better than left lateral table tilt position. Also surgery was easier to perform after wedge placement.

摘要

背景

本研究旨在比较剖宫产脊髓麻醉后,手术台倾斜与骨盆倾斜位对子宫内复苏的影响。患者……

方法

50例符合入选标准的美国麻醉医师协会(ASA)Ⅰ级和Ⅱ级患者纳入本研究,分为两组:W组(右髋下垫楔形物使骨盆倾斜)和L组(手术台向左倾斜15°),均接受脊髓麻醉。记录以下参数:心率(HR)、基线、2分钟、5分钟及此后每5分钟的平均动脉压(MAP);阻滞平均高度、阻滞节段总数、感觉阻滞起效时间(分钟)、麻黄碱剂量、低血压和心动过缓发生率、1分钟和5分钟时的阿氏评分。

结果

与手术台倾斜位相比,楔形物垫臀位时MAP下降更多,且楔形物垫臀位时低血压发生率为40%,而手术台倾斜位为12%。楔形物垫臀位时阻滞平均高度、阻滞节段总数及麻黄碱注射量均多于手术台倾斜位。

结论

与手术台左侧倾斜位相比,楔形物垫臀位在脊髓麻醉后导致低血压发生率增加和阻滞范围扩大,对胎儿无不良影响,患者对楔形物垫臀位的耐受性优于手术台左侧倾斜位。此外,楔形物垫臀位后手术操作更简便。

相似文献

本文引用的文献

2
Aortocaval compression syndrome: its 50-year history.主动脉腔静脉压迫综合征:其50年的历史。
Int J Obstet Anesth. 1992 Jan;1(2):60-4. doi: 10.1016/0959-289x(92)90002-l.
8
An inflatable obstetric anaesthetic 'wedge'.一种可充气的产科麻醉“楔形物”。
Anaesthesia. 1982 Jul;37(7):745-7. doi: 10.1111/j.1365-2044.1982.tb01314.x.
10
Time and lateral tilt at Caesarean section.剖宫产时的时间和侧倾
Br J Anaesth. 1972 May;44(5):477-84. doi: 10.1093/bja/44.5.477.

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