剖宫产腰麻后低血压的防治措施

Prevention and Control Measures of Hypotension after Spinal Anesthesia in Cesarean Section

椎管内麻醉具有简单、起效快、失败率低、药物剂量小以及手术期间肌肉松弛效果良好的优点,已成为剖宫产手术的首选麻醉方式。但在进行椎管内麻醉时,70%至80%的概率可能会发生产妇低血压。选择最有效的防治策略以实现剖宫产脊髓麻醉期间的血流动力学稳定仍然是产科麻醉学的主要挑战之一。已有多项研究探讨了容量预负荷、升压药、改变产妇体位、下肢加压等方法对预防产妇低血压反应的效果,但是,具体方法因麻醉实践的不同而有所不同。本研究的目的是总结用于预防和治疗低血压的各种方法,选择最合适的策略以降低剖宫产腰麻期间低血压的发生率。

Neuraxial anesthesia has the advantages of simplicity, rapid onset of action, low failure rate, small drug dose, and good muscle relaxation during surgery, and has become the preferred anesthesia method for cesarean section. However, maternal hypotension may occur with a 70% to 80% proba-bility during neuraxial anesthesia. Selecting the most effective preventive and therapeutic strate-gies to achieve hemodynamic stabilization during spinal anesthesia for cesarean section remains one of the major challenges in obstetric anesthesiology. Several studies have explored the effects of volume preloading, vasopressors, changes in maternal position, and lower limb compression in preventing maternal hypotensive reactions. However, specific methods vary depending on anesthe-sia practice. The purpose of this study was to summarize the various methods used to prevent and treat hypotension and to select the most appropriate strategy to reduce the incidence of hypoten-sion during spinal anesthesia for cesarean section.