[S3麻醉学视角下的“阴道足月分娩”指南:麻醉医师值得了解的知识]。

4区 医学 Q3 Medicine
Anaesthesist Pub Date : 2021-12-01 Epub Date: 2021-09-06 DOI:10.1007/s00101-021-01024-4
P Helmer, T Skazel, M Wenk, C von Kaisenberg, M Abou-Dakn, M Papsdorf, F Abu Hmeidan, S Kehl, P Meybohm, Peter Kranke
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引用次数: 0

摘要

同样于2020年出版的关于“阴道足月分娩”的新S3指南和关于剖宫产的新指南,为促进产科循证医学提供了进一步的步骤,即使分娩期间新生儿监测的确切配置仍然是当前讨论的主题。参与行为者和专业协会在编写S3准则时也充分体现了分娩医疗监督的多专业性。从麻醉学的角度来看,重要的是轴向手术仍然是产科镇痛的黄金标准。瑞芬太尼PCA是一种替代方案,可以实现可靠的镇痛,例如,当执行轴向方法有禁忌症时,如果这在当前情况下是合适的(1:1支持和适当的监测)。在一个简单的分娩过程中,严格的禁食规则是宽松的。总的来说,指导方针强调了孕妇自决和自我控制的重要性,并将母亲和儿童的安全和福祉置于最高优先地位;然而,这需要孕妇充分了解轴向镇痛的价值。为此,发起信息建议似乎很重要,这超出了通常由助产士专门组织的父母信息会议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[S3 guidelines on "full-term vaginal birth" from an anesthesiological perspective : Worthwhile knowledge for anesthesiologists].

The publication of the new S3 guidelines on "full-term vaginal birth" and the guidelines on cesarean section, also published in 2020, provide further steps towards the promotion of evidence-based medicine in obstetrics, even if the exact configuration of neonatal monitoring during birth, in particular, is still the subject of current discussions. The multiprofessionality in the medical supervision of a birth is also fundamentally well-represented in the compilation of the S3 guidelines by the participating actors and specialist societies. Important from an anesthesiological perspective is the fact that neuraxial procedures still represent the gold standard in obstetric analgesia. With remifentanil PCA an alternative option is available that enables a reliable analgesia to be accomplished, e.g. when there are contraindications to performing neuraxial methods, if this is appropriate under the prevailing circumstances (1:1 support and appropriate monitoring). During an uncomplicated birth the strict fasting rules are relaxed. Overall, the guidelines underline the importance of self-determination and self-control for the expectant mother and give the highest priority to the safety and well-being of mother and child; however, this presupposes that the expectant mother is sufficiently informed about the value of neuraxial analgesia. For this it appears to be of importance to initiate information proposals, which go beyond the usual information sessions for parents that are often organized exclusively by midwives.

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来源期刊
Anaesthesist
Anaesthesist 医学-麻醉学
CiteScore
1.60
自引率
0.00%
发文量
55
审稿时长
4-8 weeks
期刊介绍: Der Anaesthesist is an internationally recognized journal de­aling with all aspects of anaesthesia and intensive medicine up to pain therapy. Der Anaesthesist addresses all specialists and scientists particularly interested in anaesthesiology and it is neighbouring areas. Review articles provide an overview on selected topics reflecting the multidisciplinary environment including pharmacotherapy, intensive medicine, emergency medicine, regional anaesthetics, pain therapy and medical law. Freely submitted original papers allow the presentation of relevant clinical studies and serve the scientific exchange. Case reports feature interesting cases and aim at optimizing diagnostic and therapeutic strategies. Review articles under the rubric ''Continuing Medical Education'' present verified results of scientific research and their integration into daily practice.
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