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蛛网膜下腔阻滞剖宫产术后胸痛与心率血压乘积及 ST 段变化的关系。

Association of Chest Pain with Rate Pressure Product and ST-segment Changes after Sub Arachnoid Block in Caesarean Section.

机构信息

Dr Most Lubna Mariom, Consultant, Department of Anesthesia, Analgesia & Intensive Care Medicine (AA&ICM), Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:

出版信息

Mymensingh Med J. 2023 Oct;32(4):1140-1148.

Abstract

When healthy women undergo caesarean section (CS) under sub arachnoid anaesthesia, transient electrocardiographic changes, such as ST-segment depression and T-wave abnormalities, are observed. During an elective caesarean section under sub arachnoid anaesthesia, about one-third of healthy parturient experience chest pain and ECG changes suggestive of myocardial ischemia. To assess the ST-segment and Rate Pressure Product changes with chest pain in patients with elective caesarean section under subarachnoid block. The Department of Anesthesia, Analgesia and Intensive Care Medicine at Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh was the site of this prospective observational study. The study included 86 healthy women between the ages of 20 and 35 who needed an elective caesarean section under a single shot sub arachnoid block and who visited the Department of Anesthesia, Analgesia, and Intensive Care Medicine at BSMMU in Shahbagh, Dhaka from January 2019 to June 2019. In comparison to the no chest pain group, ST-segment changes among the chest pain group at delivery, 5 minute, 10 minute after delivery and at the end of the surgery were highly significant (p=0.001). Comparatively, Rate Pressure Product changes were found to be significantly higher in the group with chest pain than in the group without chest pain (p=0.001). It is concluded that there is a substantial association of chest pain with rate pressure product and ST-segment changes after subarachroid block in caesarean section.

摘要

当健康女性在蛛网膜下隙麻醉下行剖宫产术时,会观察到短暂的心电图变化,如 ST 段压低和 T 波异常。在蛛网膜下隙麻醉下择期行剖宫产术时,约三分之一的健康产妇会出现胸痛和心电图改变,提示心肌缺血。评估蛛网膜下隙阻滞下择期剖宫产术患者胸痛时 ST 段和心率血压乘积的变化。本研究在孟加拉国的 Bangabandhu Sheikh Mujib 医学大学(BSMMU)麻醉、镇痛和重症监护医学系进行。该研究纳入了 20 至 35 岁之间需要单次蛛网膜下隙阻滞下择期剖宫产的 86 名健康女性,这些女性均在达卡的 Shahbagh 的 BSMMU 麻醉、镇痛和重症监护医学系就诊。与无胸痛组相比,分娩时、分娩后 5 分钟、10 分钟和手术结束时胸痛组的 ST 段变化具有高度显著性(p=0.001)。相比之下,胸痛组的心率血压乘积变化明显高于无胸痛组(p=0.001)。结论:蛛网膜下隙阻滞下剖宫产术后胸痛与心率血压乘积和 ST 段变化有很大的关联。

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