[Incidence and complications of the aspiration of gastric contents syndrome during cesarean section in general anesthesia].

M Dindelli, M La Rosa, R Rossi, D Di Nunno, L Piva, B Pagnoni, A Ferrari
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Abstract

Maternal mortality attributed to anaesthesia, decreased in the last twenty years, has in inhalation of gastric contents one of its principal causes. Pregnant women are considered "high risk". In this retrospective investigation we studied 12,380 patients undergoing caesarean section in general anaesthesia between January 1977 and December 1991. During this period of obstetric activity the frequency of aspiration syndrome is 1:1,547 general anaesthesias (0.064%), being the 61.5% of all anaesthetic complications. In the 8 patients we had no maternal and neonatal mortality. Aspiration pneumonitis occurred in three patients. All patients were admitted at our recovery room for less than 5 days. The emergency procedure (8 cases) and a difficult tracheal intubation (4 cases) are the more important risk factors. In our clinical practice we used prevention in few cases (3.1%). Our results suggest the utility in obstetric anaesthesia of high doses of thiopental (5-6 mg/kg); these doses didn't change the principal neonatal parameters, while give in pregnant woman a light anaesthesia.

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[全麻剖宫产术中胃内容物误吸综合征的发生率及并发症]。
麻醉导致的产妇死亡率在过去二十年中有所下降,吸入胃内容物是其主要原因之一。孕妇被认为是“高危人群”。在这项回顾性调查中,我们研究了1977年1月至1991年12月在全身麻醉下进行剖腹产手术的12380例患者。在这一产科活动期间,全身麻醉时误吸综合征的发生率为1:15 547(0.064%),占所有麻醉并发症的61.5%。在8例患者中,我们没有产妇和新生儿死亡。3例患者发生吸入性肺炎。所有患者在康复室住院时间均少于5天。急诊手术(8例)和气管插管困难(4例)是更重要的危险因素。在我们的临床实践中,我们使用预防的病例很少(3.1%)。我们的研究结果表明,高剂量硫喷妥钠(5-6 mg/kg)在产科麻醉中的效用;这些剂量没有改变新生儿的主要参数,而给孕妇轻度麻醉。
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