Juhani T P, Hannele H
Department of Clinical Sciences, Tampere University, Finland.
Reg Anesth. 1993 Mar-Apr;18(2):128-31.
To evaluate the incidence and causes of complications associated with spinal anesthesia for cesarean delivery.
Prospective study, case series.
Tampere University Hospital, 284 patients scheduled for elective or nonelective cesarean delivery with spinal anesthesia. Complications occurring during spinal anesthesia with hyperbaric 0.5% bupivacaine during a 1-year period were analyzed.
Hyperbaric 0.5% bupivacaine for cesarean delivery proved to be a reliable anesthetic with a failure rate of 2.8%. The most common complications were hypotension (42%) and nausea (14%). In 81% of patients, hypotensive periods occurred before delivery. Hypotension before delivery had no correlation with low Apgar scores or with low pH in the umbilical artery of the infant. Risk factors for hypotension were elective procedures and operations without prophylactic ephedrine infusion. Nausea occurred significantly more often if a lower interspace was used for administering the subarachnoid block.
Spinal anesthesia proved to be a safe, reliable, and rapid method of anesthesia for cesarean delivery, but, in view of a high incidence of minor complications, careful patient monitoring during spinal anesthesia is necessary to make the outcome optimal for mother and fetus.
评估剖宫产脊髓麻醉相关并发症的发生率及原因。
前瞻性研究，病例系列。
坦佩雷大学医院，284例计划行择期或非择期剖宫产并接受脊髓麻醉的患者。分析在1年期间使用0.5%重比重布比卡因进行脊髓麻醉时发生的并发症。
用于剖宫产的0.5%重比重布比卡因被证明是一种可靠的麻醉剂，失败率为2.8%。最常见的并发症是低血压（42%）和恶心（14%）。81%的患者在分娩前出现低血压期。分娩前的低血压与新生儿阿氏评分低或婴儿脐动脉pH值低无关。低血压的危险因素是择期手术和未预防性输注麻黄碱的手术。如果蛛网膜下腔阻滞的给药间隙较低，恶心的发生率明显更高。
脊髓麻醉被证明是一种安全、可靠且快速的剖宫产麻醉方法，但鉴于轻微并发症的发生率较高，脊髓麻醉期间需要对患者进行仔细监测，以使母婴结局达到最佳。
