Morgan P
Department of Anaesthesia, Mount Sinai Hospital, University of Toronto, Ontario, Canada.
Can J Anaesth. 1995 Dec;42(12):1145-63. doi: 10.1007/BF03015105.
Spinal anaesthesia has been used since the 1800s but, due to a number of complications, the popularity of this technique has waxed and waned. In the 1950s, it was the most widely used method of anaesthesia and analgesia in obstetrics but it fell out of fashion with the arrival of the epidural technique which allowed a continuous method of delivering analgesia with relatively few complications. Hypotension and the high incidence of postdural puncture headaches were two reasons for the decline in the popularity of spinal anaesthesia in the young, otherwise healthy pregnant population. With the development of newer needles and bevel designs and methods whereby the incidence of hypotension can be minimized, spinal anaesthesia is making a reappearance in obstetrical anaesthesia spheres. The purpose of this article is to review the history, effects, technique, indications, contraindications and complications of this method of anesthesia as it applies to the obstetrical patient.
自19世纪以来就已使用脊髓麻醉，但由于多种并发症，该技术的受欢迎程度几经起伏。在20世纪50年代，它是产科最广泛使用的麻醉和镇痛方法，但随着硬膜外技术的出现，它逐渐失宠，硬膜外技术允许以连续方式给药镇痛，且并发症相对较少。低血压和硬膜穿刺后头痛的高发生率是脊髓麻醉在年轻、健康的孕妇群体中受欢迎程度下降的两个原因。随着新型针头、斜面设计以及可将低血压发生率降至最低的方法的发展，脊髓麻醉正在产科麻醉领域重新出现。本文旨在综述这种麻醉方法应用于产科患者时的历史、效果、技术、适应证、禁忌证和并发症。
