Upadya Madhusudan, Saneesh P J
Department of Anaesthesia, Kasturba Medical College, Manipal University, Mangalore, Karnataka, India.
Department of Anaesthesia, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman.
Indian J Anaesth. 2016 Apr;60(4):234-41. doi: 10.4103/0019-5049.179445.
Non-obstetric surgery during pregnancy posts additional concerns to anaesthesiologists. The chief goals are to preserve maternal safety, maintain the pregnant state and achieve the best possible foetal outcome. The choice of anaesthetic technique and the selection of appropriate anaesthetic drugs should be guided by indication for surgery, nature, and site of the surgical procedure. Anaesthesiologist must consider the effects of the disease process itself and inhibit uterine contractions and avoid preterm labour and delivery. Foetal safety requires avoidance of potentially dangerous drugs and assurance of continuation of adequate uteroplacental perfusion. Until date, no anaesthetic drug has been shown to be clearly dangerous to the human foetus. The decision on proceeding with surgery should be made by multidisciplinary team involving anaesthesiologists, obstetricians, surgeons and perinatologists. This review describes the general anaesthetic principles, concerns regarding anaesthetic drugs and outlines some specific conditions of non-obstetric surgeries.
孕期非产科手术给麻醉医生带来了更多担忧。主要目标是确保母体安全、维持妊娠状态并实现最佳的胎儿结局。麻醉技术的选择和合适麻醉药物的挑选应以手术指征、手术性质和部位为指导。麻醉医生必须考虑疾病过程本身的影响,抑制子宫收缩,避免早产和分娩。胎儿安全要求避免使用潜在危险药物,并确保子宫胎盘有足够的灌注持续。迄今为止,尚无麻醉药物被证明对人类胎儿有明显危害。是否进行手术的决定应由包括麻醉医生、产科医生、外科医生和围产医学专家在内的多学科团队做出。本综述描述了全身麻醉原则、对麻醉药物的担忧,并概述了一些非产科手术的特殊情况。