Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea.
Korean J Anesthesiol. 2011 Mar;60(3):214-6. doi: 10.4097/kjae.2011.60.3.214. Epub 2011 Mar 30.
Pregnancy is considered a period of high risk for cardiovascular complications in patients with Marfan syndrome. Therefore the choice of anesthetic technique for delivery should be focused on minimizing hemodynamic fluctuations, and preferably provide adequate post-operative pain control. For this purpose, neuraxial blocks, such as spinal or epidural anesthesia, may be deemed a safe option. However, dural ectasia is present in 63-92% of patients with Marfan syndrome, and the increased amount of cerebrospinal fluid volume is thought to be one of main reasons for spinal anesthesia failure. We report herein the peri-operative management of a patient with Marfan syndrome and dural ectasia for cesarean section using epidural anesthesia.
妊娠被认为是马凡综合征患者发生心血管并发症的高危时期。因此，分娩时选择麻醉技术应侧重于最大限度地减少血液动力学波动，并最好提供足够的术后疼痛控制。为此，椎管内阻滞，如脊髓或硬膜外麻醉，可能被认为是一种安全的选择。然而，马凡综合征患者中有 63-92%存在硬脊膜扩张，并且认为增加的脑脊液量是脊髓麻醉失败的主要原因之一。我们在此报告一例马凡综合征和硬脊膜扩张患者行剖宫产术时采用硬膜外麻醉的围手术期管理。
