椎管内麻醉下行剖宫产术术中肩痛1例

A Case of Shoulder Pain during Cesarean Sec-tion under Intrathecal Anesthesia

术后肩痛是腹腔镜手术后常见的并发症之一,发生率可达30%~90%。事实上,肩痛在术中即可发生,但由于麻醉对意识的影响不能及时被发现。剖宫产作为少数能在椎管内麻醉下完成的腹部手术,有关肩痛的报道甚少。引起肩痛的原因有很多,包括既往病史、CO2气腹、手术操作因素等,可根据不同情况采取多种措施处理。术中出现肩痛会引起产妇焦虑不安情绪,影响产科操作,违背舒适化医疗的理念。因此发生肩痛时不应忽视,需根据产妇情况选择合适的处理措施。

Postoperative shoulder pain is one of the common complications after laparoscopic surgery, with an incidence of 30% to 90%. In fact, shoulder pain can occur intraoperatively but cannot be detected in time due to the effect of anesthesia on consciousness. Cesarean section, as one of the few ab-dominal surgeries that can be done under intrathecal anesthesia, has few reports of shoulder pain. There are many causes of shoulder pain, including past medical history, CO2 pneumoperitoneum, and surgical operative factors, which can be handled with a variety of measures depending on the situation. Intraoperative shoulder pain can cause maternal anxiety and disturbances, affecting the obstetric operation and violating the concept of comfortable medical care. Therefore, the occurrence of shoulder pain should not be ignored, and appropriate management measures should be chosen according to the maternal situation.