神经轴麻醉下剖宫产术中的突破性疼痛:一项双中心前瞻性审计

IF 0.1 Q4 ANESTHESIOLOGY
E. Roofthooft, N. Lippens, S. Rex, S. Devroe, A. Moerman, N. Filetici, M. Van de Velde
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引用次数: 0

摘要

在世界范围内,大多数剖宫产(CS)是在神经轴麻醉下进行的。然而,轴突麻醉可能失败,术中可能出现突破疼痛。本研究的目的是评估连续CS的突破性疼痛发生率,并描述突破性疼痛的潜在危险因素。在两个中心中,前瞻性审计包括所有在轴向麻醉下进行的CS,记录突破性疼痛的发生情况以及所有可能的突破性疼痛危险因素以及替代麻醉策略。共有393名患者参加了为期6个月的研究,其中鲁汶大学206名,米德尔海姆大学187名,295名选择性CS和98名继发性CS。在所有393名参与者中,65人在CS期间经历了突破性疼痛(16.5%)。CS术中出现突破性疼痛的两个显著危险因素是:手术时间(p <0.001)和使用硬膜外药物(p=0.0032)。CS过程中的突破性疼痛对母亲来说是非常不舒服的。在这项观察性研究中,CS期间突破性疼痛的发生率为16.5%。手术时间和硬膜外药物的使用都是本次审计中CS发生突破痛的重要危险因素。为了防止CS过程中的突破性疼痛或不适,需要采取积极主动的政策。早期识别难产镇痛的硬膜外导管,术前适当的麻醉阻滞,如果手术时间延长而不是选择局部麻醉剂,则给予预防性硬膜外补充,对于预防是至关重要的。需要进一步的高质量研究来评估与颈椎病中突破性疼痛相关的许多潜在危险因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Breakthrough pain during cesarean section under neuraxial anesthesia: a two-center prospective audit
Worldwide, most Cesarean sections (CS) are performed under neuraxial anesthesia. However, neuraxial anesthesia can fail and intraoperative breakthrough pain can occur. The aim of the present investigation was to evaluate the incidence of breakthrough pain in consecutive CS and to describe the potential risk factors for breakthrough pain. In a two center, prospective audit all CS performed under neuraxial anesthesia were included and the occurrence of breakthrough pain as well as all possible risk factors of breakthrough pain were recorded as well as the alternative anesthetic strategy. A total of 393 patients were enrolled in the study over 6 months, 206 in UZ Leuven and 187 in ZNA Middelheim, 295 elective CS and 98 secondary CS. Of all 393 participants, 65 experienced breakthrough pain during the CS (16.5%). Twoo significant risk factors for breakthrough pain during CS were observed: the duration of surgery (p <0.001) and the epidural drug used (p=0.0032). Breakthrough pain during a CS is extremely uncomfortable for the mother. In this observational study, the incidence of breakthrough pain during CS was 16.5%. Duration of surgery and epidural drug used were both significant risk factors of breakthrough pain during CS in this audit. A pro-active policy is required in order to prevent breakthrough pain or discomfort during CS. Early identification of problematic epidural catheters for labor analgesia, adequate level of anesthetic block before surgery, and administration of a prophylactic epidural top-up if duration of surgery is prolonged as opposed to the choice of local anesthetic used, could be essential in the prevention. Further high-quality studies are needed to evaluate the many potential risk factors associated with breakthrough pain during CS.
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来源期刊
CiteScore
0.20
自引率
0.00%
发文量
2
期刊介绍: L’Acta Anaesthesiologica Belgica est le journal de la SBAR, publié 4 fois par an. L’Acta a été publié pour la première fois en 1950. Depuis 1973 l’Acta est publié dans la langue Anglaise, ce qui a été résulté à un rayonnement plus internationaux. Depuis lors l’Acta est devenu un journal à ne pas manquer dans le domaine d’Anesthésie Belge, offrant e.a. les textes du congrès annuel, les Research Meetings, … Vous en trouvez aussi les dates des Research Meetings, du congrès annuel et des autres réunions.
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