Schockenhoff B, Karl C
Abteilung für Anästhesiologie und operative Intensivmedizin des Allgemeinen Krankenhauses Hamburg-Barmbek.
Z Geburtshilfe Neonatol. 1995 May-Jun;199(3):99-102.
The use of regional analgesia and anesthesia in obstetrics has been established since the end of the 19th century. According to an agreement between German societies of anesthesiologists and obstetricians, regional anesthesia may be performed by both anesthesiologists and obstetricians under certain preconditions. At the RWTH Aachen hospital, the responsibility for different anesthetic techniques is divided between anesthesiologists and obstetricians in order to reduce legal risks. Caudal anesthesia is done by obstetricians, whereas anesthesiologists perform lumbar epidural anesthesia. A retrospective study over three years has shown comparable results. Lumbar epidural catheters were preferred in primiparous women, while caudal anesthesia was used more often in multiparous women. One-minute Apgar values as well as postpartum fetal arterial blood gas analyses did not differ significantly in both groups. The failure rate of caudal anesthesia was higher than that of lumbar epidural anesthesia. Blood pressure falls exceeding 20 percent of baseline were only seen in the epidural group (incidence 0.9 to 1.5 percent). The incidence of fetal bradycardia and the overall complication rate were similar in both groups.
自19世纪末以来，区域镇痛和麻醉在产科中的应用就已确立。根据德国麻醉医师协会和产科医师协会之间的一项协议，在某些前提条件下，麻醉医师和产科医师均可实施区域麻醉。在亚琛工业大学医院，为降低法律风险，不同麻醉技术的责任在麻醉医师和产科医师之间进行了划分。骶管麻醉由产科医师实施，而麻醉医师则进行腰段硬膜外麻醉。一项为期三年的回顾性研究显示了类似的结果。初产妇更倾向于使用腰段硬膜外导管，而经产妇则更常使用骶管麻醉。两组的1分钟阿氏评分以及产后胎儿动脉血气分析结果并无显著差异。骶管麻醉的失败率高于腰段硬膜外麻醉。仅在硬膜外组出现了血压下降超过基线20%的情况（发生率为0.9%至1.5%）。两组胎儿心动过缓的发生率和总体并发症发生率相似。
