Bédard J M, Richardson M G, Wissler R N
Department of Anesthesiology, University of Rochester School of Medicine and Dentistry, Strong Memorial Hospital, NY 14642, USA.
Can J Anaesth. 1999 Jun;46(6):576-80. doi: 10.1007/BF03013550.
To describe the anesthetic management of a parturient with a large acoustic neuroma undergoing general anesthesia with remifentanil for Cesarean section.
A near-term parturient presented with a large intracranial mass. Cesarean section under general anesthesia was elected one week prior to craniotomy for tumour resection. Remifentanil infusion, 0.2-1.0 microg x kg(-1) x min(-1), was used from induction to emergence of general anesthesia. The neonate was born seven minutes after the remifentanil infusion was started. She had normal umbilical cord pH and her Apgar scores were 7 and 8, at one and five minutes respectively. Although the neonate received supplemental oxygen, she did not require naloxone. Both mother and neonate made an uneventful recovery.
Remifentanil was effective in producing stable hemodynamic conditions, without severe neonatal respiratory depression, during induction and maintenance of general anesthesia for a Cesarean delivery in a parturient with a large intracranial tumour.
描述一名患有大型听神经瘤的产妇在剖宫产全身麻醉时使用瑞芬太尼的麻醉管理。
一名接近足月的产妇出现颅内巨大肿块。在开颅肿瘤切除术前一周选择全身麻醉下剖宫产。从全身麻醉诱导到苏醒期间使用瑞芬太尼输注，剂量为0.2 - 1.0微克×千克⁻¹×分钟⁻¹。瑞芬太尼输注开始后7分钟新生儿出生。其脐动脉血pH值正常，1分钟和5分钟时阿氏评分分别为7分和8分。尽管新生儿接受了辅助供氧，但未需要使用纳洛酮。母婴均顺利康复。
对于患有大型颅内肿瘤的产妇剖宫产全身麻醉诱导和维持期间，瑞芬太尼在产生稳定血流动力学状况方面有效，且无严重新生儿呼吸抑制。
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