腰麻后低血压的预防及其发生机制的研究进展

Research Progress on Prevention and Mechanism of Hypotension after Spinal An-esthesia

腰麻凭借其术后并发症低、镇痛良好、可以早期活动等优点广泛应用于临床麻醉中。但是,腰麻的并发症尤其是低血压可能延长患者住院时间、增加患者的死亡率。目前现代医学对腰麻后低血压的预防措施已有很多研究,研究认为腰麻后低血压的发生机制与交感神经被阻滞和副交感神经兴奋占优势有关。目前预防腰麻后低血压的主要措施有麻醉前的超声评估、液体治疗、血管活性药物的使用、五羟色胺受体拮抗剂的使用以及经皮穴位电刺激等。针对其发生机制,本综述旨在对目前预防腰麻后低血压的相关措施进行归纳总结,以期为预防腰麻后低血压的发生提供最优策略。

Lumbar anesthesia is widely used in clinical anesthesia due to its advantages of low postoperative complications, good analgesia, and early mobility. However, the complications of spinal anesthesia, especially hypotension, may prolong the hospital stay and increase the mortality of patients. At present, there have been many studies on the preventive measures of hypotension after spinal an-esthesia in modern medicine, and studies believe that the mechanism of hypotension after spinal anesthesia is related to sympathetic nervous system blockade and parasympathetic nervous sys-tem dominance. At present, the main measures to prevent hypotension after spinal anesthesia in-clude ultrasound evaluation before anesthesia, liquid therapy, the use of vasoactive drugs, the use of serotonin receptor antagonists, and transcutaneous electrical acupoint stimulation. In view of its mechanism, this review aims to summarize the current measures to prevent hypotension after spi-nal anesthesia, in order to provide the best strategy for preventing hypotension after spinal anes-thesia.