文件产妇肺抽吸诺案例简介一名足月妊娠32岁女性.pdfVIP

Pulmonary Aspiration in 195 the Parturient Nollag O’Rourke and William R. Camann Case Synopsis A 32-year-old woman, gravida 2, para 1, with a full-term pregnancy undergoes general anesthesia for emergency cesarean delivery owing to prolonged fetal bradycardia. The patient receives a rapid-sequence induction using thiopental and succinylcholine. The trachea is intubated using a 3.0 MacIntosh blade, cricoid pressure, and a styletted 7.5 endotracheal tube. After cesarean delivery, the patient i tubated and transferred to the postanesthesia care unit. She is breathing spontaneously with supplemental oxygen. Vital signs lude blood pressure of 110/78 mm Hg, heart rate of 96 beats per minute, and arterial oxygen saturation of 88% on 6 L of oxygen by facemask. On physical examination, the patient is noted to have bila l wheezing, and the chest radiograph reveals a right lower lobe infiltrate. The cause of delayed gastric emptying during advanced PROBLEM YSIS labor, despite satisfactory epidural gesia, is unknown. However, recent work suggests that gastric volume and acid- Definition ity at term gestation are no different from those parameters Pain relief during childbirth has long been of interest to in the nonpregnant state, during early pregnancy, or in the anesthesiologists. As the quest for optimal gesia and postpartum period. anesthesia for childbirth continues, so does that for the Iatrogenic factors that may r