To assess the impact of introducing spinal anaesthesia for obstetric operative procedures on use of general anaesthesia and quality of regional anaesthesia in a unit with an established epidural service a retrospective analysis of routinely collected data on method of anaesthesia, efficacy, and complications was carried out. Data were collected from 1988 to 1991 on 1670 obstetric patients requiring an operative procedure. The introduction of spinal anaesthesia in 1989 significantly reduced the proportion of operative procedures performed under general anaesthesia, from 60% (234/390) in 1988 to 30% (124/414) in 1991. The decrease was most pronounced for manual removal of the placenta (88%, 48/55 v 9%, 3/34) and emergency caesarean section (67%, 129/193) v 38%, 87/229). Epidural anaesthesia decreased in use most significantly for elective caesarean section (65%, 77/118 v 3% 3/113; x2=139, p<0.0001). The incidence of severe pain and need for conversion to general anaesthesia was significantly less with spinal anaesthesia (0%, 0/207 v 3%, 5/156; p<0.05). Hypotension was not a problem, and the incidence of headache after spinal anaesthetic decreased over the period studied. Introducing spinal anaesthesia therefore reduced the need for general anaesthesia and improved the quality of regional anaesthesia.
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机译:为了评估在产科手术中采用脊柱麻醉对全身麻醉的使用和局部硬膜外麻醉的质量的影响,对常规麻醉方法,疗效和并发症的数据进行了回顾性分析。从1988年至1991年收集了1670名需要手术的产科患者的数据。 1989年采用脊椎麻醉后,全麻手术的比例大大降低,从1988年的60%(234/390)降到1991年的30%(124/414)。胎盘(88%,48/55 v 9%,3/34)和紧急剖腹产(67%,129/193)v 38%,87/229)。选择性剖宫产术中硬膜外麻醉的使用最明显减少(65%,77/118 v 3%3/113; x2 = 139,p <0.0001)。脊柱麻醉的严重疼痛发生率和需要转为全身麻醉的发生率显着降低(0%,0/207对3%,5/156; p <0.05)。低血压不是问题,在所研究的时期内,脊麻后头痛的发生率下降了。因此,脊柱麻醉的引入减少了对全身麻醉的需求,并提高了区域麻醉的质量。
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