Автор: Михаил Каракозов
создано: 07.05.2009 14:10
Все исследуется и публикуется. Вот например кокрейновский обзор, то есть его резюме
Epidural versus non-epidural or no analgesia in labour Millicent Anim-Somuah, Rebecca MD Smyth, Charlotte J Howell Year: 2005
Epidurals for pain relief in labour Epidurals are widely used for pain relief in labour. There are various types, but all involve an injection into the lower back. The review of trials showed that epidurals relieve pain better than other types of pain medication, but they can lead to more use of instruments to assist with the birth. There was no difference in caesarean delivery rates, long-term backache, or effects on the baby soon after birth. However, women who used epidurals were more likely to have a longer second stage of labour, need their labour contractions stimulated, experience very low blood pressure, be unable to move for a period of time after the birth, have problems passing urine, and suffer fever. Further research on reducing the adverse outcomes with epidurals would be helpful
И мода на ЭА при КС не отсюда ли пошла
Anesthesia-related deaths during obstetric delivery in the United States, 1979-1990. Hawkins JL; Koonin LM; Palmer SK; Gibbs Anesthesiology 1997 Feb;86(2):277-84. BACKGROUND: Anesthesia-related complications are the sixth leading cause of pregnancy-related death in the United States. This study reports characteristics of anesthesia-related deaths during obstetric delivery in the United States from 1979-1990. METHODS: Each state reports deaths that occur within 1 yr of delivery to the Centers for Disease Control and Prevention as part of the ongoing Pregnancy Mortality Surveillance. Maternal death certificates (with identifiers removed) matched with live birth or fetal death certificates when available from 1979-1990 were reviewed to identify deaths due to anesthesia, the cause of death, the procedure for delivery, and the type of anesthesia provided. Maternal mortality rates per million live births were calculated. Case fatality rates and risk ratios were computed to compare general to regional anesthesia for cesarean section deliveries. RESULTS: The anesthesia-related maternal mortality rate decreased from 4.3 per million live births in the first triennium (1979-1981) to 1.7 per million in the last (1988-1990). The number of deaths involving general anesthesia have remained stable, but the number of regional anesthesia-related deaths have decreased since 1984. The case-fatality risk ratio for general anesthesia was 2.3 (95% confidence interval [CI], 1.9-2.9) times that for regional anesthesia before 1985, increasing to 16.7 (95% CI, 12.9-21.8) times that after 1985. CONCLUSIONS: Most maternal deaths due to complications of anesthesia occurred during general anesthesia for cesarean section. Regional anesthesia is not without risk, primarily because of the toxicity of local anesthetics and excessively high regional blocks. The incidence of these deaths is decreasing, however, and deaths due to general anesthesia remain stable in number and hence account for an increased proportion of total deaths. Heightened awareness of the toxicity of local anesthetics and related improvements in technique may have contributed to a reduction in complications of regional anesthesia.
- большого эпидемологического, промежду прочим, статистического исследования,
А вот мода на ЭА при перитоните, похоже наша, доморощенная, родная. Или результаты ЭА в родах автоматически можно перенести на перитонит? Можно наверное, когда подобные исследования проводить лень, когда гораздо проще на пальцах да на авось
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