Serious complications associated with epidural/spinal blockade in obstetrics: a two-year prospective study.
Serious complications associated with epidural/spinal blockade in obstetrics: a two-year prospective study.
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DOI：
10.1016/0959-289x(95)82967-f
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发表时间：
1995-07-01
影响因子：
2.8
通讯作者：
Tunstall, M E
中科院分区：
文献类型：
--
作者：
Scott, D B;Tunstall, M E
在1990年和1991年进行了一项产科硬膜外和脊髓阻滞相关并发症的前瞻性研究。联合王国的79个产科单位参加了培训。在这两年，这些单位共交付了467491辆。108133例产妇接受硬膜外阻滞，14856例产妇接受脊髓阻滞。22%的母亲在分娩时接受硬膜外镇痛，50%的剖腹产是在硬膜外麻醉或脊髓麻醉下进行的。报告了128例并发症（不包括硬膜穿刺后头痛）。其中，46例为涉及单个脊神经或外周神经的神经病变。遇到了26个意想不到的高封锁。21名母亲报告背痛，8名母亲报告尿潴留。心脏骤停两次。尽管两例患者的复苏都恢复了正常的心脏功能，但其中一名患者因去大脑而在几天后死亡。尸检发现羊水栓塞的证据。20份报告被归类为“其他”，并提供了个体临床诊断。总体并发症发生率（不包括硬膜穿刺后头痛）约为1/1000。
A prospective study of complications associated with epidural and spinal blockade in obstetrics was carried out during the years 1990 and 1991. 79 obstetric units in the United Kingdom took part. These units had a total of 467 491 deliveries during the two years. 108 133 mothers received epidural blockade and 14856 received spinal blockade. 22% of all mothers received epidural analgesia in labour, and 50% of caesarean sections were performed under either epidural or spinal anaesthesia. 128 complications (not including post dural puncture headache) were reported. Of these, 46 were neuropathies involving a single spinal or peripheral nerve. 26 unexpectedly high blockades were encountered. Backache was reported in 21 mothers and urinary retention in 8. Cardiac arrest occurred twice. Although resuscitation restored normal cardiac function in both cases, one patient was decerebrate and died some days later. Postmortem examination revealed evidence of amniotic fluid embolus. 20 reports were classified as 'miscellaneous' and presented individual clinical diagnoses. The overall complication rate (excluding post dural puncture headache) was approximately 1 per thousand.