摘要
目的新型冠状病毒肺炎(COVID-19)已成为全球流行病,COVID-19患者的中枢和外周神经系统受累且脑脊液中检测出病毒,而疫情期间COVID-19患者急诊手术如剖宫产术、骨折修复术,常采用椎管内麻醉,由此认为其安全性值得考量:1.新型冠状病毒是否因椎管穿刺术操作而进入中枢神经系统;2.椎管内麻醉患者术中可排出大量呼吸道飞沫、气溶胶,是否增加手术室内医护人员的感染风险;3.椎管内麻醉并发症如外周神经痛、硬脊膜穿刺后头痛等,可能与病毒导致神经系统受累的临床表现难以鉴别。而全身麻醉因对血脑屏障的损害风险,用于此类患者也有顾虑。如何针对COVID-19制订更完善的麻醉策略,仍需进一步的研究和循证。
The coronavirus disease 2019(COVID-19)has become a global epidemic.The central and peripheral nervous systems are involved and the coronavirus is detected in the cerebrospinal fluid in patients with COVID-19,which make the safety of neuraxial anesthesia be reconsidered which is commonly used in emergency surgeries such as cesarean section and fracture repair in these patients:1.whether the coronavirus enters the central nervous system due to the operation of lumbar puncture;2.whether the respiratory droplets and aerosols discharged by the patient increase the risk of medical staffs′infection in the operating room during the neuraxial anesthesia;3.complications of neuraxial anesthesia such as peripheral neuralgia and post dura puncture headache may be difficult to be distinguished from neurological symptoms caused by severe acute respiratory syndrome coronavirus 2 in the nervous system.However,general anesthesia also draws our concern when used in such patients for its risk of damage to the blood-brain barrier.How to formulate a better anesthesia strategy for COVID-19 still needs further research and evidence support.
作者
孙星星
刘勇
梅伟
田玉科
Sun Xingxing;Liu Yong;Mei Wei;Tian Yuke(Department of Anesthesiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)
出处
《中华麻醉学杂志》
CAS
CSCD
北大核心
2020年第11期1281-1282,共2页
Chinese Journal of Anesthesiology
