医学
2019年冠状病毒病(COVID-19)
产科
麻醉
剖宫产
神经轴阻滞
生产麻醉
剖宫产
局部麻醉
怀孕
重症监护医学
传染病(医学专业)
疾病
脊髓麻醉
病理
生物
遗传学
作者
Emilia Guasch,Nicolas Brogly,Fernando Gilsanz
出处
期刊:Current Opinion in Anesthesiology
[Ovid Technologies (Wolters Kluwer)]
日期:2020-12-10
卷期号:34 (1): 62-68
被引量:7
标识
DOI:10.1097/aco.0000000000000949
摘要
Purpose of review This review is based on the latest evidence to provide a good standard of care for COVID-19 parturients and protection to healthcare givers. Recent findings COVID-19 by itself is not an indication for cesarean section. Different publications demonstrated the efficacy of neuraxial analgesia/anesthesia for delivery. Although SARS-CoV-2 was associated with a certain neurotropism, neuraxial block was not associated with neurological damage in COVID-19 parturients, and seems as safe and effective as in normal situations. It permits to avoid a general anesthesia in case of intrapartum cesarean section. Epidural failure is a concern: it may lead to a general anesthesia in case of emergency cesarean section. Local protocols and well-trained anesthesiologists will be helpful. COVID-19 patients require special circuits and every step (transfer to and from theatre, recovery, analgesia, and so on) should be planned in advance. For cesarean section under general anesthesia, personal protection equipment must be enhanced. Postoperative analgesia with neuraxial opioids, NSAIDs, or regional blocks are recommended. COVID-19 and pregnancy increase the risk of thrombosis, so thromboprophylaxis has to be considered and protocolized. Summary Anesthetic care for delivery in COVID-19 parturients should include neuraxial blocks. Special attention should be paid on the risk of thrombosis.
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