产科麻醉意外的预防和处理PPT课件.ppt

《产科麻醉意外的预防和处理PPT课件.ppt》由会员分享，可在线阅读，更多相关《产科麻醉意外的预防和处理PPT课件.ppt（33页珍藏版）》请在淘文阁 - 分享文档赚钱的网站上搜索。

1、病人因素：特异体质；术前状况麻醉因素：麻醉选择；麻醉操作；麻醉管理仪器设备因素麻醉医生因素业务技术水平工作责任心Millers Anesthesia. 6th ed.ASA Practice Guidelines for Obstetric Anesthesia. Anesthesiology, 2007, 106(4): 843ASA Practice Guidelines for Obstetric Anesthesia. Anesthesiology, 2007, 106(4): 843nThe incidence of failed tracheal intubation in the

2、 pregnant population is perhaps 8 times higher than in the nonpregnant population.nThe first national study of anesthesia-related maternal mortality in the USA revealed that 52% of the deaths resulted from complications of general anesthesia predominantly related to airway management problems.nSoft

3、tissue changes such as airway edema are an invariable association of pregnancy, and this may contribute to difficult intubationKodali BS, et al. Anesthesiology 2008; 108:357ASA Practice Guidelines for Obstetric Anesthesia. Anesthesiology, 2007, 106(4): 843Gogarten W, et al. Eur J Anaesthesiol, 2005,

4、 22(5): 359 Hanss R, et al. Anesthesiology, 2005, 102(6): 1086 Hanss R, et al. Anesthesiology, 2006, 104(4): 635 仰卧位应激试验预测脊麻后低血压的敏感度、特异度分别为69、92 Dahlgren G, et al. Int J Obstet Anesth, 2007, 16(2): 128 Baraz1 R, et al. Anaesthesia, 2005, 60:673Baraz1 R, et al. Anaesthesia, 2005, 60:673Kuczkowski K M. Obstet Gynecol Surv. 2004,59:47n硬膜外或鞘内吗啡术后镇痛非常有效n吗啡(脂溶性最低的阿片类药物)易于随脑脊液扩散，所以镇痛部位较广，但如药物扩散到较高水平的CNS，将会导致延迟的呼吸抑制n一般在注药后410 h左右呼吸抑制表现明显，注药后23 h呼吸功能多能恢复正常 n持续输注比单次剂量安全