在分娩期间和分娩后的尿与编程间歇性外周螺栓 (PIEB) 止痛:一项前性观察性研究
Willemijn Lips1, Corina S Sie2, Liv M Freeman3
1Department of Obstetrics and Gynecology, Erasmus Medical Center, the Netherlands.
International journal of obstetric anesthesia
|January 19, 2025
概括
接受外围注射止痛的妇女在分娩期间有20.6%的尿路滞留风险. 成功的自发排泄显著降低了这种风险,这表明需要监测膀功能.
科学领域:
- 产科和妇科 产科和妇科
- 麻醉学 麻醉学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 在接受编程间歇性外周螺栓 (PIEB) 止痛的妇女中,调查分娩期间和分娩后的尿.
- 在这个人群中评估最佳的膀管理策略.
研究的目的:
- 为了确定在分娩期间和分娩后尿的发生率和危险因素,使用PIEB止痛.
- 评估膀管理策略的有效性.
主要方法:
- 对137名妇女进行前性观察性研究,她们使用PIEB接受分娩外周止痛.
- 在分娩和产后每2-3小时进行一次自发排泄后,通过空气后残留体积 (>150毫升) 评估尿.
主要成果:
- 产后尿发生在20.6%的排泄尝试中 (n=48).
- 当空化体积超过50毫升时,保留率为<10%.
- 产后保留影响了6.7% (n=9),无产妇妇女,诱导分娩和表皮切割的发病率更高.
结论:
- 在分娩期间成功的自发排泄与产后尿的低风险有关.
- 建议在无法自发排泄,排泄量小于50毫升或经历完全运动阻塞的妇女每3-4小时考虑进行导管治疗.
相关概念视频
Local Anesthetics: Clinical Application as Epidural Anesthesia
408
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
408
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
47
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
47
Local Anesthetics: Clinical Application as Spinal Anesthesia
576
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
576
Drugs for Treatment of Constipation-Predominant IBS
131
Pharmacological therapies for IBS-C are designed to alleviate abdominal discomfort and enhance bowel function. In patients with IBS-C, fiber supplements may help soften stools and decrease straining, but may also lead to increased gas production and bloating. Osmotic laxatives like milk of magnesia are frequently used to soften stools and increase stool frequency in IBS-C patients. In addition, two drugs approved for use in severe IBS-C adult cases are linaclotide (Linzess) and lubiprostone...
131
The Micturition Reflex
412
Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...
412
Parenteral Anesthetics: Overview
96
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
96


