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胎盘植入谱系疾病的麻醉考虑因素。

Anesthesia Considerations for Placenta Accreta Spectrum.

机构信息

Department of Anesthesiology, School of Medicine, University of Utah Hospital, Salt Lake City, Utah.

Department of Anesthesiology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas.

出版信息

Am J Perinatol. 2023 Jul;40(9):980-987. doi: 10.1055/s-0043-1761637. Epub 2023 Jun 19.

Abstract

Anesthesiologists are critical members of the multidisciplinary team managing patients with suspected placenta accreta spectrum (PAS). Preoperatively, anesthesiologists provide predelivery consultation for patients with suspected PAS where anesthetic modality and invasive monitor placement is discussed. Additionally, anesthesiologists carefully assess patient and surgical risk factors to choose an anesthetic plan and to prepare for massive intraoperative hemorrhage. Postoperatively, the obstetric anesthesiologist hold unique skills to assist with postoperative pain management for cesarean hysterectomy. We review the unique aspects of peripartum care for patients with PAS who undergo cesarean hysterectomy and explain why these responsibilities are critical for achieving successful outcomes for patients with PAS. KEY POINTS: · Anesthesiologists are critical members of the multidisciplinary team planning for patients with suspected placenta accreta spectrum.. · Intraoperative preparation for massive hemorrhage is a key component of anesthetic care for patients with PAS.. · Obstetric anesthesiologists have a unique skill set to manage postpartum pain and postoperative disposition for patients with PAS who undergo cesarean hysterectomy..

摘要

麻醉医生是管理疑似胎盘植入谱系(PAS)患者的多学科团队中的关键成员。术前,麻醉医生为疑似 PAS 的患者提供分娩前咨询,讨论麻醉方式和侵入性监测设备的放置。此外,麻醉医生仔细评估患者和手术风险因素,以选择麻醉计划并为大量术中出血做好准备。术后,产科麻醉医生拥有独特的技能,可以协助行剖宫产子宫切除术的患者进行术后疼痛管理。我们回顾了 PAS 患者行剖宫产子宫切除术围产期护理的独特方面,并解释了为什么这些职责对于 PAS 患者获得成功的治疗结果至关重要。

关键点

  1. 麻醉医生是规划疑似胎盘植入谱系患者的多学科团队中的关键成员。

  2. 为大量出血做好术中准备是 PAS 患者麻醉护理的关键组成部分。

  3. 产科麻醉医生具有独特的技能,可用于管理 PAS 患者行剖宫产子宫切除术后的产后疼痛和术后处置。

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