Fuzier R, Murat O, Gilbert M-L, Maguès J-P, Fourcade O
Service Orthopédie et Traumatologie, Département d'Anesthésie, CHU de Purpan, place du docteur-Baylac, TSA 40031, 31059 Toulouse cedex 09, France.
Ann Fr Anesth Reanim. 2006 May;25(5):528-31. doi: 10.1016/j.annfar.2006.01.007. Epub 2006 Feb 20.
Neuraxial blockade is usually not recommended in patients with aortic stenosis. However, neuroaxial blockade techniques such as continuous spinal or epidural anaesthesia can be tailored to minimize potentially dramatic consequences of decrease in systemic vascular resistance, often encountered after standard single shot spinal anaesthesia. We report the cases of two severe aortic stenosis patients (aortic valve area<0.5 cm2) that underwent hip surgery under continuous spinal anaesthesia. Small doses of isobaric 0.25% bupivacaine titrated to limit total dose below 5 mg, injected through the intrathecal catheter allowed the control of haemodynamic parameters. No clinical complication occurred in these two patients.
通常不建议在主动脉瓣狭窄患者中使用神经轴阻滞。然而，连续脊髓或硬膜外麻醉等神经轴阻滞技术可以进行调整，以尽量减少标准单次脊髓麻醉后常见的全身血管阻力下降可能带来的严重后果。我们报告了两名严重主动脉瓣狭窄患者（主动脉瓣面积<0.5 cm²）在连续脊髓麻醉下接受髋关节手术的病例。通过鞘内导管注入小剂量等比重0.25%布比卡因，并将总剂量控制在5mg以下，从而实现了血流动力学参数的控制。这两名患者均未发生临床并发症。
