预防非子痫前期妊娠剖宫产腰麻所致低血压

I Gusti Agung Ngurah Radhitya, Razi Ageng Pratama
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摘要

介绍。剖宫产法被广泛使用,并在孕妇中流行起来。一般情况下,该方法多采用区域麻醉(脊髓、硬膜外和CSE)。然而,许多报道术后与脊髓麻醉相关的并发症发生率。产妇低血压是脊髓麻醉术后最常见的并发症。因此,麻醉医师在剖宫产术中需注意预防腰麻低血压。方法。研究人员查阅了PubMed、BJA、Elsevier、Cochrane Library和BMC的几本科学期刊,直到2023年8月10日,以获取摘要、会议记录和全文论文,这些论文评估了在脊柱麻醉下剖腹产的非先兆子痫患者的低血压预防。此外,研究人员还研究了2016年至2023年期间进行的研究。结果,分析。研究人员检查了28篇科学文章(11.153名产妇),其中包括6种不同的预防低血压的方法。血管加压素在大多数研究中被广泛应用,低血压的发生率在4%-87,4%之间。IVCU研究报告低血压的发生率为15.3% -43%。腿抬高术一项无创技术研究报告低血压的发生率为33,3-41,4%。调整注射速度,快速注射组低血压发生率为50% ~ 75%,慢速注射组低血压发生率为36.7% ~ 61%。此外,用生理盐水稀释的格拉司琼方法报告低血压的发生率为17.5% -42%。低剂量脊髓麻醉研究报告低血压的发生率为0% - 62.5%。讨论。从所有已回顾的研究来看,血管加压素(苯肾上腺素)、腿部抬高和小剂量脊髓麻醉可以成为预防剖宫产脊柱麻醉期间低血压的主要选择,因为它可以有效地预防低血压,成本效益高,易于在每个医疗机构中应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
PREVENTING HYPOTENSION CAUSED BY SPINAL ANESTHESIA IN NON PREECLAPMTIC PREGNANCIES WITH CAESAREAN SECTION
Introduction. Caesarean method widely used and become popular among pregnant women. In general, this method mostly used regional anesthesia (spinal, epidural and CSE). However, many reports incidence of complication related to spinal anesthesia after the procedure. Maternal hypotension is the most common complication after spinal anesthesia procedure. Therefore, anesthesiologist need to prevent hypotension during spinal anesthesia in caesarean section. Method. The researcher examines several scientific journals from PubMed, BJA, Elsevier, Cochrane Library and BMC research until 10th August, 2023 for abstracts, conference proceedings, and full-text papers that evaluated prevention of hypotension in non-preeclampsia patients undergoing caesarean delivery under spinal anesthesia. In addition, the researchers examine the research conducted during 2016 to 2023. Result & Analysis. The researchers examine 28 scientific article (11.153 parturient) with 6 different methods to prevent hypotension. It was found that vasopressor is widely used in most research with incidence of hypotension varied from 4%-87,4%. IVCU studies reported the incidence of hypotension in 15,3%-43%. Leg Elevation a non-invasive technique studies reported the incidence of hypotension in 33,3-41,4%. Injection speed adjustment methods resulted incidence of hypotension in Fast injection 50 %-75% and Slow Injection in 36,7%-61%. In addition, granisetron methods diluted in normal saline reported the incidence of hypotension in 17,5%-42%. Low dose spinal anesthesia studies reported incidence of hypotension in 0% - 62,9%. Discussion. From all the research that has been reviewed, vasopressor (Phenylephrine), Leg Elevation and low dose spinal anesthesia could become primary options to prevent hypotension during spinal anesthesia in caesarean section since its effective to prevent hypotension, cost effective, and easy to applied in every medical facility.
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