Yokoyama T, Tomoda M, Kanbara T, Nishiyama T, Manabe M
Department of Anesthesiology and Resuscitology, Kochi Medical School, Nankoku 783-8505.
Masui. 2001 Mar;50(3):290-2.
Endometriosis extending into the thoracic cage or the lung might induce defect of the tissue and show catamenial symptoms, such as pneumothorax or hemothorax. These events usually occur 48 to 72 hours after menstruation. A 37-year-old woman with ten year history of recurrent catamenial pneumothorax was scheduled for removal of ovarian cyst. Since intermittent positive pressure ventilation or pneumoperitoneum might induce pneumothorax, we selected epidural anesthesia for laparotomy. Epidural cannulations were performed at Th 9/10 and L 4/5 interspaces. After administration of 2% mepivacaine (400 mg) and fentanyl (0.1 mg), the block extended from Th 6 to S 5. The surgery was done without any complication. In this case epidural anesthesia for laparotomy was useful for the patient with catamenial pneumothorax.
子宫内膜异位症累及胸廓或肺部可能导致组织缺损并出现经期症状，如气胸或血胸。这些情况通常在月经开始后48至72小时发生。一名有十年复发性经期气胸病史的37岁女性计划接受卵巢囊肿切除术。由于间歇正压通气或气腹可能诱发气胸，我们选择硬膜外麻醉进行剖腹手术。在胸9/10和腰4/5间隙进行硬膜外穿刺置管。给予2%甲哌卡因（400毫克）和芬太尼（0.1毫克）后，阻滞平面从胸6延伸至骶5。手术顺利完成，无任何并发症。在这种情况下，硬膜外麻醉用于剖腹手术对患有经期气胸的患者是有用的。
