目前产科麻醉中的热点讨论被引量：45

Current controversies in obstetric anesthesia

导出

摘要产科麻醉问世一个半世纪以来始终存在着争论。目前的争论主要包括4个问题:①分娩时实施区域性麻醉镇痛的时机是否会影响产程的长短或者宫颈扩张的速度;②区域性麻醉镇痛是否会增加阴道手术助娩和剖宫产术的危险性;③剖宫产麻醉的选择:区域麻醉还是全麻;④在非产科手术中,麻醉是否会增加产妇的风险。本文就以上问题以循证医学为基础逐一进行概括性的讨论,并介绍美国产科麻醉界的最新共识。 Since 1847 the debates and discussions concerning obstetric anesthesia have never ended. Currently, the major controversies are focused on the following four areas ： ①the effects of initiation of regional analgesia on the rate of cervical dilation;②the risks of instrumental vaginal delivery and cesarean section during the use of regional analgesia; ③the selection of anesthetics for cesarean section; and ④the risks to parturients undergoing nonobstetric surgeries. This review article will attempt to clarify these controversies with evidencebased anesthesiology. This article will also present the current consensuses in the practice of obstetric anesthesia in the US.

作者夏云

机构地区美国俄亥俄州立大学医学中心麻醉科

出处《国际麻醉学与复苏杂志》 CAS 2007年第4期380-384,共5页 International Journal of Anesthesiology and Resuscitation

关键词产科麻醉循证医学分娩镇痛区域性麻醉产程进展阴道手术助娩剖官产非产科手术胎儿监测自发性流产腹腔镜手术 obstetric anesthesia evidence based medicine labor analgesia regional analgesia labor progress instrumentalvaginal delivery cesarean section non -obstetric snrgery fetus monitoring spontaneous abortion laparoscopic surgery.

分类号 R714.3 [医药卫生—妇产科学] R614 [医药卫生—麻醉学]

引文网络
相关文献

参考文献24

1Thorp JA, Hu DH, Albin RM, et al. The effect of intrapartum epidural analgesia on nulliparous labor: a randomized, controlled, prospective trial. Am J Obstet Gynecol, 1993, 169:851-858.
2Ohel G, Harats H. Epidural anesthesia in early compared with advanced labor. Int J Gynaecol Obstet, 1994, 45:217-219.
3Holt RO, Diehl S J, Wright JW. Station and cervical dilation at epidural placement in predicting cesarean risk. Obstet Gynecol, 1999, 93:281-284.
4Chestnut DH, Vincent RD, McGrath JM,et al. Bates JN. Does early administration of epidural analgesia affect obstetric outcome in nulliparous women who are receiving intravenous oxytocin? Anesthesiology, 1994, 80 : 1193-1200.
5Luxman D, Wolman I, Groutz A, et al. The effect of early epidural block administration of the progression and outcome of labor. Int J Obstet Anesth, 1998,7 : 161-164.
6Wong CA, Scavone BM, Peaceman AM, et al. The risk of cesarean delivery with neuraxial analgesia given early versus late in labor. N Engl J Med, 2005, 352:655-665.
7Marucci M, Cinnella G, Perchiazzi G, et al. Patient - requested Neuraxial Analgesia for Labor : Impact on Rates of Cesarean and Instrumental Vaginal Delivery. Anesthesiology, 2007,106 : 1035-1045.
8Sharma SK, Alexander JM, Messick G, et al. Cesarean delivery: a randomized trial of epidural analgesia versus intravenous meperidine analgesia during labor in nulliparous women. Anesthesiology, 2002, 96 : 546-551.
9Leighton BL, Halpern SH. Epidural analgesia: effects on labor progress and maternal and neonatal outcome. Semin Perinatal, 2002, 26 : 122- 135.
10Goyert GL, Bottoms SF, Treadwell MC, et al. The physician factor in cesarean birth rates. N Engl J Med,1989, 320:706-709.