What Are the Different Types of C-Section Anesthesia?

For anesthesia in gynecological and obstetric surgery, the organs are located deep in the pelvis, and the operation requires perfect relaxation of the abdominal muscles.

Anesthesia for gynecological and obstetric surgery

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For anesthesia in gynecological and obstetric surgery, the organs are located deep in the pelvis, and the operation requires perfect relaxation of the abdominal muscles.

Chinese name

Anesthesia for gynecological and obstetric surgery

Foreign name

Anesthesia for gynecologic and obstetric surgery

Surgical approach

Transabdominal or transvaginal resection

1. Acute patients are often accompanied by a large amount of blood loss in the abdominal cavity, mainly with hemorrhagic shock. It is not uncommon for blood pressure to be unclear and conscious, indicating that intra-abdominal bleeding has reached half of the patient's total blood volume. Judging is not difficult.

2. Immediate blood transfusion and laparotomy under local anesthesia. Vasoactive drugs should not be used until the bleeding has stopped.

3. Once the place is controlled, rapid blood transfusion can be performed, and if necessary, it can be supplemented with an appropriate amount of vasoactive drugs to make the systolic blood pressure recover to 14 kpa (mmhg) as soon as possible.

4. Blood transfusion at home: due to fibrinogen precipitation and a large amount of blood clots in the abdominal cavity, the sucked blood is not easy to coagulate. Add a small amount of sodium citrate (200ml blood, add 2.5% sodium citrate 10ml) . Please note:

(1) Prepare an autologous blood transfusion device before surgery.

(2) The blood in the abdominal cavity should be sucked out before operation.

(3) For those who have performed puncture of the posterior fornix, in order to avoid infection, it is not advisable to return. Therefore, for those who have been clearly judged and there is more blood in the abdominal cavity, no posterior fornix puncture should be performed.

5. If the patient is out of shock and cannot tolerate local anesthesia, general anesthesia may be switched.

1. Generally, it is performed in the clinic.

2. To prevent cardiovascular reactions during dilation, such as slow heart rate, decreased blood pressure, and cold sweat, routinely apply a sufficient amount of atropine before surgery.

3. Anesthesia method:

(1) Fortification: Appropriate sedative and analgesics are used, and pethidine 50mg plus haloperidine 5mg is more commonly used.

(2) Propofol intravenous anesthesia:

Wake up quickly and recover well, which is quite suitable for the short operation of artificial abortion, and the patient can have no pain.

After everything is ready for the operation, slowly inject the medicine from the upper limbs at a dose of 2mg / kg and keep the veins open. You can start the operation after falling asleep.

Intravenous injection of 0.5-1 mg / kg every 5 minutes until the end of the operation. After stopping the drug, the patients were awake quickly.

An anesthesia machine or artificial respirator should be provided, and breathing and blood pressure should be closely monitored.

(3) It is estimated that those who have difficulty in operation and long operation time can use ramie or epidural block.

Definition of anesthesia for gynecological and obstetric surgery

After birth, the fetus changes from intrauterine to extrauterine life. At this time, due to various reasons (including intrauterine suffocation, intrapulmonary disease, pressure and nerve sensor function of chemoreceptors, etc.), the newborn cannot produce spontaneous breathing or obstructed airway (Secretion, fetal feces, etc.), causing hypoxemia and hypercapnia, that is, asphyxia of the newborn.

Anesthesia classification for gynecological and obstetric surgery

Use the apgar score method to observe five indicators (heart rate, respiration, muscle vitality, response to stimulus, skin color) two times at 1 minute and 5 minutes after birth. Each item is composed of 0-2 points, so the full score is 10 Minute.

1.0-3 is divided into severe asphyxia.

2.4-7 is divided into mild asphyxia.

3.8-10 points are normal.

Anesthesia resuscitation for gynecological and obstetric surgery

1. All fetuses should squeeze out the mucus in the mouth, nose and throat in time after the fetal head is delivered to clear the respiratory tract.

2. After the fetus is delivered, the apgar score is less than 7 points. After clearing and attracting respiratory secretions, spontaneous breathing cannot be established, that is, endotracheal intubation, neonatal direct laryngoscope and neonatal tracheal intubation.

3. There is still no spontaneous breathing after intubation. After being slightly attracted by tracheal intubation with a thin plastic tube, artificial respiration is started with pure oxygen. When squeezing the breathing sac by hand, the pressure started at 2.94kpa (30cmh2o) to blow the lung lobe, and then decreased to 0.98kpa (10cmh2o), hiyxo 30-40 times / min.

4, to ensure effective circulation: neonatal asphyxia will not cause cardiac arrest in a short time, so if the breathing problem can be solved, the circulation can be restored quickly. If the heartbeat stops, it means that the suffocation time is very long, and only extracardiac compression can be performed immediately, and 0.1 mg of epinephrine is injected from the umbilical vein at the same time.

5. In order to reduce acidemia, 5% nahco32mmol / kg can be injected from the umbilical vein.

6. When the resuscitation is correct but the effect is not good, it should be considered whether there is congenital malformation or intracranial hemorrhage.

7. Children with severe asphyxia still need to be treated with oxygen after resuscitation. When it is asserted that irds (idiopathic respiratory distress syndrome) require mechanical ventilation.