Ioscovich A, Briskin A, Fadeev A, Grisaru-Granovsky S, Halpern S
Department of Anesthesia, Shaare Zedek Medical Center, Jerusalem, Israel.
J Clin Anesth. 2006 Dec;18(8):631-4. doi: 10.1016/j.jclinane.2006.05.016.
Management of parturients with a history of Fontan procedure requires careful monitoring of cardiovascular parameters and anticipation of potential complications. We describe potential pitfalls in a parturient with atriopulmonary Fontan circulation, who received epidural analgesia for labor and who later required emergency cesarean section. Low-dose local anesthetic in combination with meperidine provided excellent perioperative epidural analgesia and cardiovascular stability. Epidural analgesia during labor offered optimal pain relief and facilitated conversion to surgical anesthesia for an emergency cesarean section.
对于有Fontan手术史的产妇，管理需要仔细监测心血管参数并预见潜在并发症。我们描述了一名接受心房肺Fontan循环的产妇在分娩时接受硬膜外镇痛、后来需要紧急剖宫产的潜在陷阱。低剂量局部麻醉药联合哌替啶提供了出色的围手术期硬膜外镇痛和心血管稳定性。分娩时的硬膜外镇痛提供了最佳的疼痛缓解，并便于转换为紧急剖宫产的手术麻醉。
