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[产科实践中局部区域麻醉的并发症(作者译)]

[Complications of loco-regional anaesthesia in obstetrical practice (author's transl)].

作者信息

Lecron L

出版信息

Anesth Analg (Paris). 1981;38(3-4):141-5.

PMID:7258709
Abstract

Complications of loco-regional anaesthesia in obstetrics are usually due to several factors: 1. choice of drugs: this must be judicious, taking into account duration of effect, potency and eventual maternal and foetal toxicity. This rule includes also morphinic drugs; 2. choice of technique: taking into consideration the stage of labour and also the eventual surgical procedure. Paracervical block must be avoided because of the numerous side-effects, chiefly foetal distress. Spinal anaesthesia is indicated only for instrumental procedures or caesarian section, with the usual reserves about headaches, severe hypotension. Peridural anaesthesia may present some complications, like extensive peridural anaesthesia, hypotension. In eclampsia and gemellarity, loco-regional, anaesthesia must be induced with the utmost caution. Moreover, an unrecognized uterine rupture may happen during labour under medullary anaesthesia if the patient had previously a caesarian section.

摘要

产科局部区域麻醉的并发症通常由多种因素引起

  1. 药物选择:必须谨慎选择,要考虑作用持续时间、效力以及最终的母体和胎儿毒性。这条规则也适用于吗啡类药物;2. 技术选择:要考虑产程阶段以及最终的手术操作。由于有许多副作用,主要是胎儿窘迫,必须避免宫颈旁阻滞。脊髓麻醉仅适用于器械操作或剖宫产,通常要注意头痛、严重低血压等问题。硬膜外麻醉可能会出现一些并发症,如广泛的硬膜外麻醉、低血压。在子痫和双胎妊娠时,必须极其谨慎地进行局部区域麻醉。此外,如果患者之前做过剖宫产,在脊髓麻醉下分娩时可能会发生未被识别的子宫破裂。

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