Zhang Yi, Zeng Qingjun, Cui Haishan, Guo Shuang, Wang Linyun, Mo Yunbo
Maternal and Child Health Hospital of Wanzhou District, Chongqing, China.
Maternal and Child Health Hospital of Wanzhou District, Chongqing, China
BMJ Open. 2025 Sep 2;15(9):e106002. doi: 10.1136/bmjopen-2025-106002.
The visceral traction response (VTR) occurring during caesarean sections with neuraxial anaesthesia represents a common and significant complication that can greatly affect perioperative results and maternal contentment. Traditional methods for managing VTR frequently face limitations due to differences among individuals, highlighting the necessity for tailored approaches that incorporate personalised risk evaluations, cutting-edge monitoring techniques and enhanced treatment options. Despite the substantial potential of this emerging idea to tackle such an important clinical issue, there is a notable absence of a comprehensive review of the current evidence available.
This protocol for a scoping review outlines a methodical strategy to chart the existing research landscape related to precision management of VTR in the context of caesarean delivery performed under neuraxial anaesthesia. By developing a conceptual framework, assessing the combined benefits of cutting-edge technologies and summarising tailored intervention techniques, this review aims to pinpoint key attributes, critical areas and new research directions, ultimately contributing to the enhancement of clinical practices and the formulation of rigorous future studies.
This research will thoroughly follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. The eligibility criteria will be outlined using the population, concept, context framework. A comprehensive search across various international and Chinese databases (such as PubMed/MEDLINE, Embase, Cochrane Library, Web of Science, CINAHL, Scopus, Google Scholar, China National Knowledge Infrastructure, WanFang and VIP) will be performed for literature published until March 2025, with a final update conducted before submission. Two reviewers will independently assess the literature and extract data. The data will be synthesised in a narrative format, supplemented by tabular and graphical representations, including conceptual framework diagrams and technology application matrices.
As this is a secondary analysis of published literature, ethics approval is not required. Results will be disseminated through peer-reviewed publications and presentations at international conferences, establishing an evidence foundation for clinical pathways and guiding future research initiatives. The protocol is registered with the Open Science Framework (https://doi.org/10.17605/OSF.IO/VS94Y).
在剖宫产术中采用神经轴索麻醉时出现的内脏牵拉反应（VTR）是一种常见且严重的并发症，会极大地影响围手术期结果和产妇满意度。由于个体差异，传统的VTR管理方法常常面临局限性，这凸显了采用个性化风险评估、先进监测技术和强化治疗方案的定制方法的必要性。尽管这一新兴理念在解决如此重要的临床问题方面具有巨大潜力，但目前尚无对现有证据的全面综述。
本范围综述方案概述了一种系统策略，以梳理在神经轴索麻醉下进行剖宫产时VTR精准管理的现有研究情况。通过构建概念框架、评估先进技术的综合效益以及总结定制干预技术，本综述旨在确定关键属性、关键领域和新的研究方向，最终促进临床实践的改进并为严谨的未来研究提供指导。
本研究将严格遵循系统评价和Meta分析扩展版范围综述的首选报告项目指南。将使用人群、概念、背景框架来概述纳入标准。将对截至2025年3月发表的文献在各种国际和中国数据库（如PubMed/MEDLINE、Embase、Cochrane图书馆、Web of Science、CINAHL、Scopus、谷歌学术、中国知网、万方和维普）中进行全面检索，并在提交前进行最终更新。两名评审员将独立评估文献并提取数据。数据将以叙述形式进行综合，并辅以表格和图形表示，包括概念框架图和技术应用矩阵。
由于这是对已发表文献的二次分析，无需伦理批准。研究结果将通过同行评审出版物和在国际会议上的报告进行传播，为临床路径建立证据基础并指导未来的研究计划。该方案已在开放科学框架（https://doi.org/10.17605/OSF.IO/VS94Y）上注册。
