Kang Xianhui, Zhang Rong, He Huiliang, Yao Yongxing, Zheng Yueying, Wen Xiaohong, Zhu Shengmei
Department of Anesthesiology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2020 May 25;49(2):249-252. doi: 10.3785/j.issn.1008-9292.2020.03.04.
Since the coronavirus disease 2019 (COVID-19) affects the cardio-pulmonary function of pregnant women, the anesthetic management and protection of medical staff in the cesarean section is significantly different from that in ordinary surgical operation. This paper reports a case of cesarean section for a woman with COVID-19, which was successfully performed in the First Affiliated Hospital of Zhejiang University School of Medicine on February 8, 2020. Anesthetic management, protection of medical staff and psychological intervention for the pregnant woman during the operation were discussed. Importance has been attached to the preoperative evaluation of pregnant women with COVID-19 and the implementation of anesthesia plan. For moderate patients, intraspinal anesthesia is preferred in cesarean section, and try to reduce its influence in respiration and circulation in both maternal and infant; general anesthesia with endotracheal intubation should be adopted for severe or critically ill patients. Ensure the safety of medical environment, and anesthetists should carry out level-Ⅲ standard protection. Special attention and support should be paid to maternal psychology: fully explanation before operation to reduce anxiety; relieve the discomfort during operation, so as to reduce tension; avoid the bad mood due to pain after operation.
由于2019冠状病毒病(COVID-19)会影响孕妇的心肺功能,剖宫产手术中麻醉管理及医护人员防护与普通外科手术有显著不同。本文报道了1例新型冠状病毒肺炎孕妇剖宫产手术病例,该手术于2020年2月8日在浙江大学医学院附属第一医院成功实施。文中探讨了手术过程中的麻醉管理、医护人员防护及对孕妇的心理干预。重视新型冠状病毒肺炎孕妇的术前评估及麻醉方案的实施。对于中度患者,剖宫产首选椎管内麻醉,并尽量减少其对母婴呼吸和循环的影响;对于重度或危重症患者应采用气管插管全身麻醉。确保医疗环境安全,麻醉医生应实施三级标准防护。应特别关注产妇心理:术前充分解释以减轻焦虑;术中缓解不适,以减轻紧张;避免术后因疼痛导致不良情绪。