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[产科麻醉:久经考验且值得信赖的方法、当前标准及新挑战]

[Anesthesia in obstetrics: Tried and trusted methods, current standards and new challenges].

作者信息

Kranke P, Annecke T, Bremerich D H, Hanß R, Kaufner L, Klapp C, Ohnesorge H, Schwemmer U, Standl T, Weber S, Volk T

机构信息

Klinik und Poliklinik für Anästhesiologie, Zentrum Operative Medizin, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland.

Klinik für Anästhesiologie und Operative Intensivmedizin, Universitätsklinikum Köln, Köln, Deutschland.

出版信息

Anaesthesist. 2016 Jan;65(1):3-21. doi: 10.1007/s00101-015-0129-0.

Abstract

Obstetric analgesia and anesthesia have some specific aspects, which in particular are directly related to pathophysiological alterations during pregnancy and also to the circumstance that two or even more individuals are always affected by complications or therapeutic measures. This review article deals with some evergreens and hot topics of obstetric anesthesia and essential new knowledge on these aspects is described. The article summarizes the talks given at the 16th symposium on obstetric anesthesia organized by the Scientific Committee for Regional Anaesthesia and Obstetric Anaesthesia within the German Society of Anaesthesiology. The topics are in particular, special features and pitfalls of informed consent in the delivery room, challenges in education and training in obstetric anesthesia, expedient inclusion of simulation-assisted training and further education on risk minimization, knowledge and recommendations on fasting for the delivery room and cesarean sections, monitoring in obstetric anesthesia by neuraxial and alternative procedures, the possibilities and limitations of using ultrasound for lumbal epidural catheter positioning in the delivery room, recommended approaches in preparing peridural catheters for cesarean section, basic principles of cardiotocography, postoperative analgesia after cesarean section, the practice of early bonding in the delivery room during cesarean section births and the management of postpartum hemorrhage.

摘要

产科镇痛与麻醉有一些特定的方面,这些方面尤其与孕期的病理生理改变直接相关,也与并发症或治疗措施总是会影响两个甚至更多个体的情况相关。这篇综述文章探讨了产科麻醉的一些常新且热门的话题,并阐述了这些方面的重要新知识。文章总结了由德国麻醉学会区域麻醉与产科麻醉科学委员会组织的第16届产科麻醉研讨会上的发言。主题尤其包括产房知情同意的特点与陷阱、产科麻醉教育与培训中的挑战、合理纳入模拟辅助培训及关于风险最小化的继续教育、产房和剖宫产禁食的知识与建议、产科麻醉中神经轴索及其他方法的监测、产房使用超声定位腰段硬膜外导管的可能性与局限性、剖宫产硬膜外导管准备的推荐方法、胎心监护的基本原则、剖宫产术后镇痛、剖宫产分娩时产房早期母婴亲密接触的实践以及产后出血的管理。

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