Abstract
Topicality. Currently, intrapartum fetal health care is aimed at an adequate choice of anesthetic aid used during delivery to minimize the negative impact. Despite the wide range of currently existing anesthetics, the choice of anesthetic drug is limited by its negative effect not only on the fetus, but also on the contractile activity of the uterus, which significantly reduces the number of anesthetics used in obstetric practice.The purpose of this study is to analyze domestic and foreign literature in order to study the effect of anesthesia on the condition of the fetus. Material and methods. In the course of this study, an analysis of modern Russian and foreign literary sources, as well as the latest scientific works in the field of methods of general and regional anesthesia in the field of obstetrics and gynecology, was carried out.Results. Almost all drugs used for general anesthesia in obstetric practice can have a negative effect on the fetus. Neuroaxial pain relief methods are leading in obstetric practice, but their use is associated with complications that can lead to an adverse outcome not only from the mother, but also from the fetus. One such complication is the risk of arterial hypotension. It is interesting that comparative studies of general and regional anesthesia methods during operative delivery differ in the results obtained. Regarding the issue of anesthesia of natural births, the information of the Congress of the American Society of Anesthesiologists (lecture C.A. Wong (Chicago) āNeuroaxial Labor Analgesia and Prognancy Outcome: Factand Fictionā) remains relevant, according to which neuroaxial anesthesia methods do not affect the condition of the fetus, provided that the mother has stable hemodynamics.Conclusion. Due to the appearance and release of neuroaxial pain relief methods, completely unreasonably little attention is paid to the issues of general anesthesia of pregnant women, while according to the results of a study of scientific literary sources, it was revealed that this method of pain relief in obstetric practice is accompanied by the most direct and mediated effects on the fetus. Neuroaxial pain relief methods have practically no effect on the condition of the fetus, provided that the mother has stable hemodynamics.
Highlights
ŠŠŗŃŃŠ°Š»ŃŠ½Š¾ŃŃŃ Š Š½Š°ŃŃŠ¾ŃŃŠµŠµ Š²ŃŠµŠ¼Ń ŠøŠ½ŃŃŠ°Š½Š°ŃŠ°Š»ŃŠ½Š°Ń Š¾Ń ŃŠ°Š½Š° Š·Š“Š¾ŃŠ¾Š²ŃŃ ŠæŠ»Š¾Š“Š° Š½Š°ŠæŃŠ°Š²Š»ŠµŠ½Š° Š½Š° Š°Š“ŠµŠŗŠ²Š°ŃŠ½ŃŠ¹ Š²ŃŠ±Š¾Ń Š°Š½ŠµŃŃŠµŠ·ŠøŠ¾Š»Š¾Š³ŠøŃŠµŃŠŗŠ¾Š³Š¾ ŠæŠ¾ŃŠ¾Š±ŠøŃ, ŠæŃŠøŠ¼ŠµŠ½ŃŠµŠ¼Š¾Š³Š¾ Š² Ń Š¾Š“Šµ ŃŠ¾Š“Š¾ŃŠ°Š·ŃŠµŃŠµŠ½ŠøŃ Š“Š»Ń Š¼ŠøŠ½ŠøŠ¼ŠøŠ·Š°ŃŠøŠø Š¾ŃŃŠøŃŠ°ŃŠµŠ»ŃŠ½Š¾Š³Š¾ Š²Š»ŠøŃŠ½ŠøŃ
Despite the wide range of currently existing anesthetics, the choice of anesthetic drug is limited by its negative effect on the fetus, and on the contractile activity of the uterus, which significantly reduces the number of anesthetics used in obstetric practice
Almost all drugs used for general anesthesia in obstetric practice can have a negative effect on the fetus
Summary
ŠŠŗŃŃŠ°Š»ŃŠ½Š¾ŃŃŃ Š Š½Š°ŃŃŠ¾ŃŃŠµŠµ Š²ŃŠµŠ¼Ń ŠøŠ½ŃŃŠ°Š½Š°ŃŠ°Š»ŃŠ½Š°Ń Š¾Ń ŃŠ°Š½Š° Š·Š“Š¾ŃŠ¾Š²ŃŃ ŠæŠ»Š¾Š“Š° Š½Š°ŠæŃŠ°Š²Š»ŠµŠ½Š° Š½Š° Š°Š“ŠµŠŗŠ²Š°ŃŠ½ŃŠ¹ Š²ŃŠ±Š¾Ń Š°Š½ŠµŃŃŠµŠ·ŠøŠ¾Š»Š¾Š³ŠøŃŠµŃŠŗŠ¾Š³Š¾ ŠæŠ¾ŃŠ¾Š±ŠøŃ, ŠæŃŠøŠ¼ŠµŠ½ŃŠµŠ¼Š¾Š³Š¾ Š² Ń Š¾Š“Šµ ŃŠ¾Š“Š¾ŃŠ°Š·ŃŠµŃŠµŠ½ŠøŃ Š“Š»Ń Š¼ŠøŠ½ŠøŠ¼ŠøŠ·Š°ŃŠøŠø Š¾ŃŃŠøŃŠ°ŃŠµŠ»ŃŠ½Š¾Š³Š¾ Š²Š»ŠøŃŠ½ŠøŃ. Š ŃŠ¾Š¾ŃŠ²ŠµŃŃŃŠ²ŠøŠø Ń ŠŗŠ»Š°ŃŃŠøŃŠøŠŗŠ°ŃŠøŠµŠ¹ FDA ŠæŃŠ¾ŠæŠ¾ŃŠ¾Š» Š¾ŃŠ½Š¾ŃŃŃ Šŗ ŠŗŠ°ŃŠµŠ³Š¾ŃŠøŠø B ā ŠøŃŃŠ»ŠµŠ“Š¾Š²Š°Š½ŠøŃ Š½Š° Š¶ŠøŠ²Š¾ŃŠ½ŃŃ Š½Šµ Š²ŃŃŠ²ŠøŠ»Šø ŃŠøŃŠŗŠ° Š¾ŃŃŠøŃŠ°ŃŠµŠ»ŃŠ½Š¾Š³Š¾ Š²Š¾Š·Š“ŠµŠ¹ŃŃŠ²ŠøŃ Š½Š° ŠæŠ»Š¾Š“, Š½Š°Š“Š»ŠµŠ¶Š°ŃŠøŃ ŠøŃŃŠ»ŠµŠ“Š¾Š²Š°Š½ŠøŠ¹ Ń Š±ŠµŃŠµŠ¼ŠµŠ½Š½ŃŃ Š¶ŠµŠ½ŃŠøŠ½ Š½Šµ Š±ŃŠ»Š¾, Š¾Š“Š½Š°ŠŗŠ¾ ŠæŃŠ¾Š²ŠµŠ“ŠµŠ½Š½ŃŠµ ŠŗŠ»ŠøŠ½ŠøŃŠµŃŠŗŠøŠµ ŠøŃŠæŃŃŠ°Š½ŠøŃ Š“Š¾ŠŗŠ°Š·Š°Š»Šø ŠµŠ³Š¾ ŃŠæŠ¾ŃŠ¾Š±Š½Š¾ŃŃŃ ŠæŃŠ¾Š½ŠøŠŗŠ°ŃŃ ŃŠµŃŠµŠ· ŠæŠ»Š°ŃŠµŠ½ŃŠ°ŃŠ½ŃŠ¹ Š±Š°ŃŃŠµŃ, ŃŃŠ¾ Š½Šµ ŠøŃŠŗŠ»ŃŃŠ°ŠµŃ Š²Š¾Š·Š¼Š¾Š¶Š½Š¾ŃŃŠø ŠµŠ³Š¾ Š¾ŃŃŠøŃŠ°ŃŠµŠ»ŃŠ½Š¾Š³Š¾ Š²Š»ŠøŃŠ½ŠøŃ Š½Š° Š¾ŃŠ³Š°Š½ŠøŠ·Š¼ ŠæŠ»Š¾Š“Š°, Š² ŃŠ²ŃŠ·Šø Ń ŃŠµŠ¼ Š²ŃŃŠ¾ŠŗŠøŠµ Š“Š¾Š·Ń Š“Š°Š½Š½Š¾Š³Š¾ ŠæŃŠµŠæŠ°ŃŠ°ŃŠ° ŠæŃŠ¾ŃŠøŠ²Š¾ŠæŠ¾ŠŗŠ°Š·Š°Š½Ń Š“Š»Ń ŃŠ¾Š“Š¾ŃŠ°Š·ŃŠµŃŠµŠ½ŠøŃ.
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