P Helmer, T Skazel, M Wenk, C von Kaisenberg, M Abou-Dakn, M Papsdorf, F Abu Hmeidan, S Kehl, P Meybohm, Peter Kranke
{"title":"[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]。","authors":"P Helmer, T Skazel, M Wenk, C von Kaisenberg, M Abou-Dakn, M Papsdorf, F Abu Hmeidan, S Kehl, P Meybohm, Peter Kranke","doi":"10.1007/s00101-021-01024-4","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":50796,"journal":{"name":"Anaesthesist","volume":"70 12","pages":"1031-1039"},"PeriodicalIF":0.0000,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[S3 guidelines on \\\"full-term vaginal birth\\\" from an anesthesiological perspective : Worthwhile knowledge for anesthesiologists].\",\"authors\":\"P Helmer, T Skazel, M Wenk, C von Kaisenberg, M Abou-Dakn, M Papsdorf, F Abu Hmeidan, S Kehl, P Meybohm, Peter Kranke\",\"doi\":\"10.1007/s00101-021-01024-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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. 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[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.
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.