Foetal well-being during labour is of utmost importance. One of the ways to attempt to assess foetal well-being is by recording foetal heart rate (FHR). Loss of variability and deceleration patterns are known to be as...Foetal well-being during labour is of utmost importance. One of the ways to attempt to assess foetal well-being is by recording foetal heart rate (FHR). Loss of variability and deceleration patterns are known to be associated with foetal distress. Decelerations and foetal bradycardia have been described after any type of effective labour analgesia. This review addresses the questions if certain analgesic techniques and/or analgesics lead to clinically relevant FHR changes, what is their aetiology, and how we should manage these FHR changes.展开更多
BACKGROUND Primary ciliary dyskinesia(PCD)is an inherited autosomal-recessive disorder of impaired mucociliary clearance characterized by chronic respiratory diseases,otolaryngological diseases,central nervous system ...BACKGROUND Primary ciliary dyskinesia(PCD)is an inherited autosomal-recessive disorder of impaired mucociliary clearance characterized by chronic respiratory diseases,otolaryngological diseases,central nervous system abnormalities,reproductive system abnormalities,and cardiac function abnormalities.General anesthesia in these patients is associated with a higher incidence of respiratory complications than in patients without the disease.CASE SUMMARY A 16-year-old male patient was referred to the emergency room complaining of right ankle pain due to distal tibiofibular fracture.Three years prior,he had been diagnosed with PCD.At that time,he had experienced several episodes of pneumonia,sinusitis,and chronic middle ear infections,for which he underwent surgical interventions.At the current admission,he presented with cough and sputum but no other respiratory symptoms.A chest computed tomography scan revealed centrilobular ground-glass opacities in both lower lobes and a calcified nodule in the left lower lobe.For the surgical procedure and postoperative pain management,combined spinal-epidural anesthesia was employed.The patient’s postoperative pain score was measured by the numerical rating scale(NRS).On the day of surgery,his NRS was 5 points.By the second postoperative day,the NRS score had decreased to 2–3 points.The epidural catheter was removed on the fourth day following the operation.The patient was subsequently discharged no respiratory complications.CONCLUSION We performed combined spinal-epidural anesthesia in a patient with PCD.The patient experienced no additional respiratory complications and was discharged with a low NRS score for pain.展开更多
目的比较腰硬联合麻醉(CSEA)与硬膜外麻醉在分娩镇痛中的应用效果。方法选取2019年1月至2022年3月于上饶东信第五医院分娩的40名产妇作为研究对象,按照随机数字表法分为对照组与观察组,每组20例。对照组实施硬膜外麻醉,观察组实施腰硬...目的比较腰硬联合麻醉(CSEA)与硬膜外麻醉在分娩镇痛中的应用效果。方法选取2019年1月至2022年3月于上饶东信第五医院分娩的40名产妇作为研究对象,按照随机数字表法分为对照组与观察组,每组20例。对照组实施硬膜外麻醉,观察组实施腰硬联合麻醉,比较两组镇痛起效时间、产程(第一产程、第二产程)、应激指标[白细胞介素-6(IL-6)、肾上腺素(ADR)与皮质醇(Cor)、一氧化氮(NO)]、疼痛数字分级法(NRS)评分及镇痛药物用量及自控镇痛次数、产后泌乳指标[泌乳始动时间、产后12h催乳素(PRL)]和泌乳情况及不良反应发生情况。结果观察组镇痛起效时间、第一产程、第二产程均短于对照组,差异有统计学意义(P<0.05)。镇痛5、30min,观察组NRS评分均低于对照组,差异有统计学意义(P<0.05);两组镇痛前后其他时间点NRS评分比较差异无统计学意义。分娩后24h,两组Cor、ADR、IL-6、NO水平均高于产前,但观察组低于对照组,差异有统计学意义(P<0.05)。观察组芬太尼用量、罗哌卡因用量、自控镇痛次数均少于对照组,差异有统计学意义(P<0.05)。观察组泌乳始动时间短于对照组,产后12 h PRL水平、泌乳有效率均高于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论与硬膜外麻醉相比,CSEA用于分娩镇痛中效果良好,可有效缩短产程,缓解患者疼痛感,控制机体应激水平,促进产妇产后泌乳,减少不良反应的发生。展开更多
文摘Foetal well-being during labour is of utmost importance. One of the ways to attempt to assess foetal well-being is by recording foetal heart rate (FHR). Loss of variability and deceleration patterns are known to be associated with foetal distress. Decelerations and foetal bradycardia have been described after any type of effective labour analgesia. This review addresses the questions if certain analgesic techniques and/or analgesics lead to clinically relevant FHR changes, what is their aetiology, and how we should manage these FHR changes.
文摘BACKGROUND Primary ciliary dyskinesia(PCD)is an inherited autosomal-recessive disorder of impaired mucociliary clearance characterized by chronic respiratory diseases,otolaryngological diseases,central nervous system abnormalities,reproductive system abnormalities,and cardiac function abnormalities.General anesthesia in these patients is associated with a higher incidence of respiratory complications than in patients without the disease.CASE SUMMARY A 16-year-old male patient was referred to the emergency room complaining of right ankle pain due to distal tibiofibular fracture.Three years prior,he had been diagnosed with PCD.At that time,he had experienced several episodes of pneumonia,sinusitis,and chronic middle ear infections,for which he underwent surgical interventions.At the current admission,he presented with cough and sputum but no other respiratory symptoms.A chest computed tomography scan revealed centrilobular ground-glass opacities in both lower lobes and a calcified nodule in the left lower lobe.For the surgical procedure and postoperative pain management,combined spinal-epidural anesthesia was employed.The patient’s postoperative pain score was measured by the numerical rating scale(NRS).On the day of surgery,his NRS was 5 points.By the second postoperative day,the NRS score had decreased to 2–3 points.The epidural catheter was removed on the fourth day following the operation.The patient was subsequently discharged no respiratory complications.CONCLUSION We performed combined spinal-epidural anesthesia in a patient with PCD.The patient experienced no additional respiratory complications and was discharged with a low NRS score for pain.
文摘目的比较腰硬联合麻醉(CSEA)与硬膜外麻醉在分娩镇痛中的应用效果。方法选取2019年1月至2022年3月于上饶东信第五医院分娩的40名产妇作为研究对象,按照随机数字表法分为对照组与观察组,每组20例。对照组实施硬膜外麻醉,观察组实施腰硬联合麻醉,比较两组镇痛起效时间、产程(第一产程、第二产程)、应激指标[白细胞介素-6(IL-6)、肾上腺素(ADR)与皮质醇(Cor)、一氧化氮(NO)]、疼痛数字分级法(NRS)评分及镇痛药物用量及自控镇痛次数、产后泌乳指标[泌乳始动时间、产后12h催乳素(PRL)]和泌乳情况及不良反应发生情况。结果观察组镇痛起效时间、第一产程、第二产程均短于对照组,差异有统计学意义(P<0.05)。镇痛5、30min,观察组NRS评分均低于对照组,差异有统计学意义(P<0.05);两组镇痛前后其他时间点NRS评分比较差异无统计学意义。分娩后24h,两组Cor、ADR、IL-6、NO水平均高于产前,但观察组低于对照组,差异有统计学意义(P<0.05)。观察组芬太尼用量、罗哌卡因用量、自控镇痛次数均少于对照组,差异有统计学意义(P<0.05)。观察组泌乳始动时间短于对照组,产后12 h PRL水平、泌乳有效率均高于对照组,差异有统计学意义(P<0.05)。观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论与硬膜外麻醉相比,CSEA用于分娩镇痛中效果良好,可有效缩短产程,缓解患者疼痛感,控制机体应激水平,促进产妇产后泌乳,减少不良反应的发生。
