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产科医生行椎管内麻醉后的产后并发症

Postpartum complications following neuraxial anaesthesia for obstetric physicians.

作者信息

Lawrence Heather, Morton Adam

机构信息

Obstetrics Department, Mater Health, Raymond Terrace, South Brisbane, Australia.

Obstetric Medicine, Mater Health, Raymond Terrace, South Brisbane, Australia.

出版信息

Obstet Med. 2023 Sep;16(3):142-150. doi: 10.1177/1753495X221146329. Epub 2022 Dec 25.

Abstract

Neuraxial analgesia and anaesthesia are widely accepted and well-tolerated modes of delivery analgesia, being employed in up to 76% of vaginal deliveries and 94% of caesarean deliveries in the United States. A cause of considerable concern for postpartum women, their family and caring health professionals is the occurrence of unexplained postpartum complications, not only for management in the index pregnancy, but the uncertain risk of recurrence in future pregnancies. Complications of neuraxial blocks may impact significantly on the ability of mothers to care for and bond with their newborn. The reported incidence of temporary neurological deficit following obstetric neuraxial blocks is 1 in 3900 procedures, and the risk of permanent neurological harm estimated to be between 1 in 80,000 and 1 in 320,425 procedures. Obstetric physicians may be asked to review women with postpartum complications following neuraxial blocks. This article reviews complications that may be seen following neuraxial blocks for delivery.

摘要

椎管内镇痛和麻醉是广泛接受且耐受性良好的分娩镇痛方式,在美国,高达76%的阴道分娩和94%的剖宫产采用这种方式。产后妇女及其家人以及护理保健专业人员相当关注的一个问题是不明原因的产后并发症的发生,这不仅关乎本次妊娠的处理,还涉及未来妊娠复发的不确定风险。椎管内阻滞的并发症可能会对母亲照顾新生儿并与之建立亲密关系的能力产生重大影响。据报道,产科椎管内阻滞术后暂时性神经功能缺损的发生率为每3900例手术中有1例,永久性神经损伤的风险估计在每80000例至每320425例手术中有1例。产科医生可能会被要求对椎管内阻滞术后出现产后并发症的妇女进行评估。本文综述了分娩时椎管内阻滞术后可能出现的并发症。

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What's New in Neuraxial Labor Analgesia.椎管内分娩镇痛的新进展
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本文引用的文献

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Complications and liability related to regional and neuraxial anesthesia.与区域麻醉和神经阻滞麻醉相关的并发症和责任。
Best Pract Res Clin Anaesthesiol. 2019 Dec;33(4):487-497. doi: 10.1016/j.bpa.2019.07.007. Epub 2019 Jul 19.

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