Gavand Y, Krausz-Grignard M, Barrucand B, Courtois L, Samain E
Service d'anesthésie réanimation, hôpital Saint-Jacques, CHU de Besançon, université de Franche-Comté, place Saint-Jacques, 25000 Besançon, France.
Ann Fr Anesth Reanim. 2011 Sep;30(9):688-91. doi: 10.1016/j.annfar.2011.06.009.
A 41-year-old woman suffering from a left cor triatrium, pregnant for the first time, was hospitalized for a caesarean section in the context of a pulmonary arterial hypertension with severe anaemia. The anaesthetic strategy which was decided on involved setting up a haemodynamic monitoring prior to induction of a general anaesthetia with etomidate, remifentanil and succinylcholine and maintained with propofol, sufentanil and cisatracurium. This strategy allowed the hemodynamic to be stabilized during the operation. The improvement of the arterial pulmonary hypertension immediately after coming out of the operating theatre allowed the patient to be briefly monitored in the intensive care unit and to be allowed home on the 10th day following the operation. The patient's cardiopathy was corrected in the 5th month after the birth.
一名41岁患有左心房三房心的初产妇,因重度贫血合并肺动脉高压而住院接受剖宫产手术。所决定的麻醉策略包括在使用依托咪酯、瑞芬太尼和琥珀胆碱诱导全身麻醉前建立血流动力学监测,并在术中持续使用丙泊酚、舒芬太尼和顺式阿曲库铵维持麻醉。该策略使手术过程中的血流动力学得以稳定。术后即刻肺动脉高压得到改善,患者在重症监护病房接受了短暂监测,并于术后第10天出院。患者的心脏病在产后第5个月得到纠正。