Department of Anesthesiology and Intensive Care, Second University of Naples, Italy.
Eur Rev Med Pharmacol Sci. 2011 Apr;15(4):458-60.
Multiple sclerosis is common among women of childbearing age. Neuraxial blocks have been administered to them with reluctance because of the hypothetical risk that local anesthetics might be more histotoxic to neural tissue already compromised by multiple sclerosis. In spite of the lack of uniform guidelines on disorders in pregnancy like multiple sclerosis, and of the published data that sometimes contrast each other, experience gained in recent years has indicated that regional anesthesia is safe even in these patients, but there aren't many published cases. We describe the case of a pregnant woman affected by multiple sclerosis in which we administered spinal anesthesia for a cesarean section, and we analyzed the aspects that literature defines as critical points in this group of patients. The results were favorable with regard to the level, intensity and duration of anesthesia. No neurological exacerbations were recognized during the hospital stay, nor during the follow-up that lasted 12 months.
多发性硬化症在育龄妇女中较为常见。由于局部麻醉剂可能对已经受到多发性硬化症影响的神经组织更具组织毒性的假设风险,因此她们接受椎管内阻滞的意愿较低。尽管对于像多发性硬化症这样的妊娠疾病缺乏统一的指南,并且发表的数据有时相互矛盾,但近年来的经验表明,区域麻醉在这些患者中也是安全的,但发表的病例并不多。我们描述了一例患有多发性硬化症的孕妇,我们为她行剖宫产术实施了脊麻,并分析了文献中定义为这组患者关键点的方面。结果在麻醉的水平、强度和持续时间方面均是有利的。在住院期间和随访的 12 个月内,均未出现神经恶化。