对重复剖腹产的麻醉方法:一个前性队列研究
Jacob Weinstein1, Rasha Muhalwes1, Alexander Ronenson1
1Department of Anesthesiology, Perioperative Medicine and Pain Treatment, Shaare Zedek Medical Center, affiliated with the Faculty of Medicine, The Hebrew University, 12 Shmu'el Bait Street, PO Box 3235, Jerusalem, Israel.
概括
脊柱麻醉对于大多数高阶重复剖腹产 (CS) 是安全的. 标准麻醉技术是合适的,但建议谨慎对怀疑的胎盘accreta频谱病例.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 外科手术的结果
背景情况:
- 重复剖腹产 (CS) 会增加外科手术的复杂性.
- 麻醉策略对于重复CS的孕产妇和新生儿的结果至关重要.
研究的目的:
- 为了比较低级重复CS (LOR-CS) 和高级重复CS (HOR-CS) 的麻醉技术.
- 在重复的CS中,评估麻醉在不同复杂的手术中是否合适.
主要方法:
- 从2021年1月到2021年12月,对1057名从2021年1月到2021年12月重复CS接受治疗的患者进行前性队列研究.
- 在LOR-CS (1-2之前的CS) 和HOR-CS (≥3之前的CS) 之间对麻醉特征和适当性的比较.
主要成果:
- 在84.3%的HOR-CS病例中使用脊柱麻醉.
- 与LOR-CS (38分钟) 相比,HOR-CS (42分钟) 的手术时间更长 (p=0.004).
- 在HOR-CS中,中度至重度的粘附是常见的,与更长的手术时间相关;估计的血液损失没有显著差异.
结论:
- 脊柱麻醉,标准监测和定期麻醉设置对大多数HOR-CS.安全.
- 麻醉管理应该是个性化的,特别是在怀疑有胎盘增殖谱的病例中.
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