2019冠状病毒病流行期间剖宫产的麻醉管理

Zhi-qiang Zhou, Xingxing Sun, Shiyong Li, L. Wan, A. Luo, Dongji Han
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引用次数: 0

摘要

2020年1月24日至2020年2月9日在华中科技大学同济医学院附属同济医院急诊剖宫产的36名产妇,均佩戴医用外科口罩,回顾性纳入本研究。麻醉管理是在三级医疗保护措施下进行的。专用麻醉设备单独消毒。麻醉药品仅用于一名患者,麻醉用品使用一次性医疗用品。当新生儿需要复苏时,应避免接触传播,为新生儿提供早期隔离和核酸检测严重急性呼吸综合征冠状病毒2型疑似病例率为11%,术前临床诊断病例率为17%,术后诊断总阳性率为31%。神经轴麻醉率为86%,全麻率为14%,脊椎穿刺时间为(15±7)min,全麻下气管插管时间为(2 1±1 3)min,手术时间为(95±36)min,失血量为(276±166)ml。新生儿Apgar评分为8.8±0.5。有1名新生儿的母亲在手术后被诊断为2019冠状病毒病,出生36小时时采集口咽拭子样本,核酸检测拭子检测出严重急性呼吸系统综合征冠状病毒2型阳性。截至2020年2月10日,一名参与手术的麻醉师被诊断为感染了严重急性呼吸系统综合征冠状病毒2型。总之,2019年妊娠期间冠状病毒疾病的诊断更困难,有必要在三级医疗保护下对剖宫产进行麻醉管理。尽管在三级医疗保护下麻醉手术的难度增加,麻醉师只要经过严格的培训并遵守防护规程,就可以进行规范的麻醉管理,保障母婴和麻醉师自身的安全©2020中华医学会
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Anesthesia management for cesarean section during coronavirus disease 2019 epidemic
Thirty-six puerperas who underwent emergency cesarean section at Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 24, 2020 to February 9, 2020, who all wore medical surgical masks, were retrospectively included in this study Anesthesia management was performed under tertiary medical protection measures A dedicated anesthesia equipment was separately sterilized Narcotic drugs were used for one patient only, and disposable medical supplies were used for anesthetic supplies Contact transmission should be avoided when a neonate required resuscitation, and early isolation and nucleic acid testing were provided for the neonates The rate of suspected cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was 11% , and the rate of clinically diagnosed cases was 17% before surgery The rate of clinically diagnosed cases of SARS-CoV-2 was 22%, the rate of confirmed cases was 8%, and the total positive rate of diagnosis was 31% after surgery The rate of neuraxial anesthesia was 86%, the rate of general anesthesia was 14%, the time of spinal puncture was (15±7) min, the time of tracheal intubation under general anesthesia was (2 1±1 3) min, the operation time was (95±36) min, and blood loss was (276±166) ml The Apgar score of newborns was 8 8±0 5 There was 1 neonate whose mother was diagnosed as having coronavirus disease 2019 after operation, an oropharyngeal swab specimen was obtained at 36 h of birth, and the swab was tested positive for SARS-CoV-2 by nucleic acid testing As of February 10, 2020, an anesthesiologist involved in the operation was diagnosed to have infection by SARS-CoV-2 In conclusion, diagnosis of coronavirus disease 2019 during pregnancy is more difficult, it is necessary to perform anesthesia management for cesarean section under tertiary medical protection Although the difficulty in anesthesia operation is increased under tertiary medical protection, anesthesiologists can carry out standardized anesthesia management and guarantee the safety of maternal and infants and anesthesiologists themselves as long as they are rigorously trained and adhere to protective protocols © 2020 Chinese Medical Association
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来源期刊
中华麻醉学杂志
中华麻醉学杂志 Medicine-Anesthesiology and Pain Medicine
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0.10
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11211
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Constructing the system of epidemic prevention training to help the construction of the disciplinary connotation Anesthesia management for cesarean section during coronavirus disease 2019 epidemic Pediatric anesthesia-related specification during coronavirus disease 2019 epidemic Expert recommendations for tracheal intubation in critically ill patients with coronavirus disease 2019 (Version 1.0) Fighting against coronavirus disease 2019 outbreak: improvement in anesthesia-related infection control
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