[Incidence of venous air embolism in parturients during cesarean section with regional anesthesia].

H Lu, Y Y Chiang, Z C Lin, C D Chou, P Y Hong, R Y Cheng, H K Leung
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Abstract

The purpose of the study is to probe the situation of venous air embolism (VAE) and the accompanying complications occurring in Chinese parturients in Taiwan during Cesarean section. Sixty ASA physical status class I-II parturients who were subjected to cesarean section under regional anesthesia were evaluated. The sensor of the Doppler device was placed on the anterior chest to detect the rumbles of air when it came to pass, and simultaneously the signs and symptoms following VAE were observed. Our results demonstrated that the usual or normal Doppler heart sound changed in 38 parturients out of 60 (63.3%), and the alteration occurred very often when the uterus was being incised (81.6%), or sutured (97.4%), and concurred strong correlation with such signs and symptoms such as chest tightness or precordial pain (78.9%), shortness of breath (60.5%), and change of heart rate or blood pressure (86.8%). The method of anesthesia (spinal or epidural block) did not have effect on the occurrence of VAE, but different surgical approaches and different positions in which the patients were posed during operation did apparently bring about VAE of variable degree. Besides, supplying of oxygen could mitigate the symptoms produced by VAE. Consequently, the application of Doppler monitor during Cesarean section can detect VAE earlier and more efficiently and thus provides information timely treatment.

[区域麻醉剖宫产术中产妇静脉空气栓塞的发生率]。
摘要本研究旨在探讨台湾华人产妇剖宫产术中发生静脉空气栓塞(VAE)的情况及并发症。对60例在区域麻醉下行剖宫产术的ASA I-II级产妇进行身体状况评估。将多普勒装置传感器置于前胸,检测空气通过时的隆隆声,同时观察VAE的体征和症状。结果显示,60例产妇中有38例(63.3%)发生正常或正常的多普勒心音改变,这种改变经常发生在子宫切开(81.6%)或缝合(97.4%)时,并与胸闷或心前疼痛(78.9%)、呼吸短促(60.5%)、心率或血压变化(86.8%)等体征和症状密切相关。麻醉方式(脊髓或硬膜外阻滞)对VAE的发生没有影响,但不同手术入路和术中不同体位对VAE的发生有不同程度的明显影响。此外,供氧可减轻VAE引起的症状。因此,剖宫产术中应用多普勒监护仪可以更早、更有效地发现VAE,及时提供信息治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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