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产科麻醉问世一个半世纪以来始终存在着争论。目前的争论主要包括4个问题:①分娩时实施区域性麻醉镇痛的时机是否会影响产程的长短或者宫颈扩张的速度;②区域性麻醉镇痛是否会增加阴道手术助娩和剖宫产术的危险性;③剖宫产麻醉的选择:区域麻醉还是全麻;④在非产科手术中,麻醉是否会增加产妇的风险。本文就以上问题以循证医学为基础逐一进行概括性的讨论,并介绍美国产科麻醉界的最新共识。
There has always been controversy over the one and a half centuries since the advent of obstetric anesthesia. The current debate mainly includes four questions: (1) whether the timing of regional anesthesia analgesia during childbirth will affect the length of labor or the rate of cervical dilatation; (2) whether regional anesthesia and analgesia will increase vaginal delivery and caesarean section The risk of cesarean section anesthesia; regional anesthesia or general anesthesia; ④ in non-obstetric surgery, anesthesia will increase the risk of maternal. This article discusses the above issues one by one based on evidence-based medicine one by one and introduces the latest consensus of the American anesthesia community.