全身麻醉在产科剖宫产的应用

Application of General Anesthesia in Obstetric Cesarean Section

目前,在产科剖宫产手术麻醉方式的选择上以椎管内麻醉为主,但在某些情况下如产妇拒绝椎管内麻醉、区域阻滞失败等,以及产妇患有严重合并症如严重心血管系统疾病时,仍需采用全身麻醉。文章从剖宫产全麻过程中气道保护措施、麻醉药物选择、超声辅助麻醉等的研究进展进行综述,认为产科全身麻醉需要考虑母婴安全,主要考虑安全的麻醉管理及麻醉药物的选择等方面的影响,并结合产科特点合理利用快速康复理念优化围产期各项措施,以提高产妇舒适度。

At present,the intraspinal anesthesia is the predominant choice in obstetric cesarean section,however in some cases,such as maternal refusal of intraspinal anesthesia,regional block failure,and maternal with serious complications such as serious cardiovascular disease,still need to use general anesthesia.This paper reviews the research progress of airway protection measures,anesthetic selection and ultrasound-assisted anesthesia in the process of general anesthesia for cesarean section.It is considered that maternal and infant safety should be considered in obstetric general anesthesia,and the influence of safe anesthesia management and anesthetic selection should be mainly considered.Combined with the characteristics of obstetrics,the rapid recovery concept should be reasonably used to optimize the perinatal measures,so as to improve the lying-in woman's comfort.