Kurdi Madhuri S, Ramaswamy Ashwini H
Department of Anaesthesiology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India.
Indian J Anaesth. 2018 May;62(5):330-336. doi: 10.4103/ija.IJA_139_18.
The menstrual cycle is a physiological phenomenon that is accompanied by several hormonal fluctuations involving oestrogen and progesterone. Oestrogen and progesterone exert several physiological effects. There are many questions pertaining to the influence of the physiology of menstruation on anaesthesia. We attempted to find out whether the phase of the menstrual cycle can alter the physiological functions during anaesthesia, the perioperative management and outcomes. We performed a literature search in Google Scholar, PubMed and Cochrane databases for original and reviewed articles on the phases of the menstrual cycle and their relation to anaesthesia-related physiological parameters to find an answer to these questions. Many studies have shown that women, perimenstrually, may have increased pain perception, exacerbation of systemic diseases, vocal cord/peripheral oedema and post-operative nausea and vomiting (PONV). Some of the other notable findings in most studies were sleep disturbances in the luteal phase (LP), increased occurrence of PONV in the ovulatory phase and a lower requirement of intravenous sedative and anaesthetic drug requirements in the LP. We found contradictory results concerning pain perception and PONV in relation to the follicular and LPs. However, we found that literature regarding the phase of the menstrual cycle and the haemodynamic response to intubation, anaesthesia-induced hypnosis and perioperative blood loss is relatively scarce. Thus, there is a need to conduct good quality research on these topics.
月经周期是一种生理现象，伴随着涉及雌激素和孕激素的多种激素波动。雌激素和孕激素发挥多种生理作用。关于月经生理对麻醉的影响存在许多问题。我们试图弄清楚月经周期的阶段是否会改变麻醉期间的生理功能、围手术期管理及结局。我们在谷歌学术、PubMed和Cochrane数据库中进行了文献检索，以查找关于月经周期各阶段及其与麻醉相关生理参数关系的原创及综述文章，以找到这些问题的答案。许多研究表明，女性在月经期间可能会出现疼痛感知增加、全身性疾病加重、声带/外周水肿以及术后恶心呕吐（PONV）。大多数研究中的其他一些显著发现包括黄体期（LP）的睡眠障碍、排卵期PONV发生率增加以及LP期静脉镇静和麻醉药物需求量降低。我们发现关于卵泡期和LP期的疼痛感知及PONV存在相互矛盾的结果。然而，我们发现关于月经周期阶段与插管的血流动力学反应、麻醉诱导的催眠及围手术期失血的文献相对较少。因此，有必要对这些主题进行高质量的研究。
