Thomas I, Thomas M, Scrutton M
Department of Obstetric Anaesthesia, St Michael's Hospital, Bristol, UK.
Int J Obstet Anesth. 2006 Jul;15(3):254-6. doi: 10.1016/j.ijoa.2006.01.002.
We report the use of spinal anaesthesia in a patient with hereditary spastic paraplegia who presented for manual removal of placenta following a normal vaginal delivery. This 18-year-old primigravida had been diagnosed with hereditary spastic paraplegia at 8 years of age when neurological examination revealed mild bilateral lower limb spasticity. A 25-gauge Whitacre spinal anaesthetic needle was inserted at the L3-4 intervertebral space and 0.5% plain bupivacaine 2 mL plus fentanyl 25 microg administered. The procedure was uneventful. At 24 hours postoperatively, there was full neurological recovery to pre-anaesthetic levels. The hereditary spastic paraplegias are a group of neurological disorders characterised by a slowly progressing spastic paraparesis. The neurological disorder and its anaesthetic implications are reviewed.
我们报告了一名遗传性痉挛性截瘫患者在正常阴道分娩后行人工胎盘剥离术时使用脊髓麻醉的情况。这名18岁的初产妇在8岁时被诊断为遗传性痉挛性截瘫，当时神经检查显示双侧下肢轻度痉挛。在L3 - 4椎间隙插入一根25G的Whitacre脊髓麻醉针，并给予2 mL 0.5%的布比卡因原液加25微克芬太尼。手术过程顺利。术后24小时，神经功能完全恢复至麻醉前水平。遗传性痉挛性截瘫是一组以缓慢进展的痉挛性轻截瘫为特征的神经疾病。本文对该神经疾病及其麻醉相关问题进行了综述。
