产程硬膜外镇痛效果不佳患者剖宫产麻醉管理算法

Vaida Sonia, Cattano Davide, Hurwitz Debra, Mets Berend

Department of Anesthesiology, Penn State Milton S. Hershey Medical Center, Hershey, Pennysylvania, 17033, USA.

Preoperative clinic, Department of Anesthesiology, The University of Texas Medical School at Houston, Houston, Texas, 77030, USA.

F1000Res. 2015 Apr 24;4:98. doi: 10.12688/f1000research.6381.1. eCollection 2015.

The management of a patient presenting with unsatisfactory labor epidural analgesia poses a severe challenge for the anesthetist wanting to provide safe anesthetic care for a cesarean delivery. Early recognition of unsatisfactory labor analgesia allows for replacement of the epidural catheter. The decision to convert labor epidural analgesia to anesthesia for cesarean delivery is based on the urgency of the cesarean delivery, airway examination, and the existence of a residual sensory and motor block. We suggest an algorithm which is implemented in our department, based on the urgency of the cesarean delivery.

对于想要为剖宫产提供安全麻醉护理的麻醉医生而言，处理分娩时硬膜外镇痛效果不佳的患者是一项严峻挑战。尽早识别出分娩镇痛效果不佳，有助于更换硬膜外导管。将分娩硬膜外镇痛转换为剖宫产麻醉的决策，基于剖宫产的紧急程度、气道检查以及残余感觉和运动阻滞的情况。我们建议采用一种基于剖宫产紧急程度的算法，该算法已在我们科室实施。