印度尼西亚万隆梅琳达妇女医院5000多名患者全麻下选择性剖宫产的经验

Open Access Macedonian Journal of Medical Sciences Pub Date : 2023-04-28 DOI:10.3889/oamjms.2023.11608

Dewi Yulianti Bisri, Tatang Bisri

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引用次数: 0

摘要

背景:尽管手术的安全性，剖宫产术(CS)仍然与较高的产妇死亡率和发病率相关。CS可在脊髓麻醉、硬膜外麻醉、脊髓和硬膜外联合麻醉或全身麻醉下进行。由于其对母亲和新生儿的副作用，CS的麻醉选择仍然是一个有争议的问题。CS麻醉选择的成功见于孕产妇和新生儿结局，其中Apgar评分用于在第一分钟和第五分钟评估新生儿。目的:本研究旨在通过Apgar评分测定剖宫产术中全麻的效果。研究对象和方法:这是一项横断面分析回顾性研究，研究对象为印度尼西亚万隆梅林达妇女医院18年间(2004年7月- 2022年6月)接受全麻下择期剖宫产手术的7131例患者。在这项研究中，来自医疗记录的数据被用来分析新生儿和产妇的结局。结果:7131例全身麻醉下的新生儿无产妇死亡或通气困难;然而，观察到母亲术后恶心呕吐(PONV)(15例)、插管困难(6例)、低血压(5例)、需要输血(5例)和术后镇痛(所有病例)的发生率。在新生儿中，IUFD和严重先天性疾病导致的新生儿死亡(3)，新生儿Apgar评分在1分钟和5分钟分别为9分和10分。结论:剖宫产术中全麻不存在低Apgar评分的影响。

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Elective Cesarean Section under General Anesthesia Experience in more than 5,000 Patients at Melinda Women Hospital Bandung-Indonesia

BACKGROUND: Despite the safe nature of the procedure, cesarean section (CS) is still associated with higher maternal mortality and morbidity rates. CS can be performed under spinal, epidural, combined spinal and epidural, or general anesthesia. The choice of anesthesia for CS is still a matter of debate due to its side effects on mothers and neonates. Success in the selection of anesthesia in CS is seen in maternal and neonatal outcomes, where the Apgar score is used for assessing neonates in the first and fifth minutes. AIM: This study aimed to determine the effect of general anesthesia in cesarean section as measured by Apgar score. SUBJECT AND METHODS: This was a cross-sectional analytical retrospective study on a total sample of 7,131 patients who underwent elective cesarean section under general anesthesia during 18 years (July 2004–June 2022) at Melinda Women Hospital Bandung Indonesia. In this study, data from medical records were used to analyze neonatal and maternal outcomes. RESULTS: Of the 7,131 CS under general anesthesia cases, no maternal death or difficult ventilation was found; however, the incidence of postoperative nausea and vomiting (PONV) (15), difficult intubation (6), hypotension (5), and need for blood transfusion (5), and postoperative analgesia (all cases) were observed in the mothers. In neonates, neonatal death caused by IUFD and severe congenital disease (3), and a mean neonatal Apgar score of 9 and 10 at 1 and 5 min were identified. CONCLUSION: No low Apgar score is found as the effect of general anesthesia in cesarean section.

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来源期刊

Open Access Macedonian Journal of Medical Sciences Medicine-Medicine (all)

自引率

0.00%

发文量

1225

期刊介绍： Open Access Macedonian Journal of Medical Sciences (OAMJMS) [formerly known as Macedonian Journal of Medical Sciences] is a top-tier open access medical science journal published by the ID Design 2012/DOOEL Skopje, Rajko Zhinzifov No 48, 1000 Skopje, Republic of Macedonia. OAMJMS is an international, modern, general medical journal covering all areas in the medical sciences, from basic studies to large clinical trials and cost-effectiveness analyses. We publish mostly human studies that substantially enhance our understanding of disease epidemiology, etiology, and physiology; the development of prognostic and diagnostic technologies; trials that test the efficacy of specific interventions and those that compare different treatments; and systematic reviews. We aim to promote translation of basic research into clinical investigation, and of clinical evidence into practice. We publish occasional studies in animal models when they report outstanding research findings that are highly clinically relevant. Our audience is the international medical community as well as educators, policy makers, patient advocacy groups, and interested members of the public around the world. OAMJMS is published quarterly online version. The Open Access Macedonian Journal of Medical Sciences (OAMJMS) publishes Medical Informatics, Basic Science, Clinical Science, Case Report, Brief Communication, Public Health, Public Policy, and Review Article from all fields of medicine and related fields. This journal also publishes, continuously or occasionally, the bibliographies of the members of the Society, medical history, medical publications, thesis abstracts, book reviews, reports on meetings, information on future meetings, important events and dates, and various headings which contribute to the development of the corresponding scientific field.