产科麻醉风险与防范.pptVIP

硬膜外麻醉，腰麻，腰硬联合麻醉（CSE)少用全麻麻醉方式的选择有赖于：剖宫产的原因(急症等)患者要求麻醉师的综合判断对患者安全舒适对新生儿镇静作用最小优化手术医生的工作条件剖宫产麻醉方式的选择全麻相关的死亡率非常高(Hawkins1997,Hibbard1996,Rasmussen1994)全麻其他的危害:FailedendotrachealintubationAspirationpneumonitisPostoperativenauseaandvomitingSedationofthebaby+++GeneralAnesthesiaindicatedforseverefetaldistressWeighrisk/benefitratiosLowerthebartoperformawakeintubationUsealgorithms全麻很少用于剖宫产手术Maternalhypotensionisthemostfrequentcomplicationofspinalanesthesia(100%intheabsenceofprophylaxis)Untreatedhypotensioncanposeseriousriskst