主动脉瓣狭窄并关闭不全产妇行硬膜外镇痛及阴道分娩。
Epidural analgesia and vaginal delivery in a patient with aortic stenosis and insufficiency.
机构信息
Department of Anesthesiology and Intensive Care, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey.
出版信息
Med Princ Pract. 2011;20(6):574-6. doi: 10.1159/000330027. Epub 2011 Oct 4.
OBJECTIVE
To report a successful vaginal delivery using slow infusion of epidural analgesia in a patient with both severe aortic stenosis and insufficiency.
CLINICAL PRESENTATION AND INTERVENTION
A 26-year-old primigravid patient presented to our hospital for delivery. She had aortic stenosis and insufficiency due to rheumatic fever. Although the obstetrician recommended cesarean section owing to her cardiac status, she insisted upon vaginal delivery. We performed low-dose epidural analgesia with 10 ml of 0.125% ropivacaine and 20 μg fentanyl. She had spontaneous vaginal delivery without complication.
CONCLUSION
This case showed that in spite of the cardiac pathology, vaginal delivery under low-dose slow infusion of epidural analgesia was successful and therefore may be a safe alternative to cesarean section for cardiac patients.
目的
报告一例在患有严重主动脉瓣狭窄和关闭不全的患者中，通过硬膜外镇痛缓慢输注成功进行阴道分娩的病例。
临床表现与干预
一名 26 岁的初产妇因风湿热导致主动脉瓣狭窄和关闭不全，就诊于我院准备分娩。尽管产科医生建议因她的心脏状况而行剖宫产术，但她坚持阴道分娩。我们采用低剂量硬膜外镇痛，即 0.125%罗哌卡因 10 毫升加 20μg 芬太尼，患者顺利自然分娩，无并发症。
结论
尽管存在心脏病理学改变，但在低剂量缓慢输注硬膜外镇痛下进行阴道分娩是成功的，因此可能是心脏患者替代剖宫产术的一种安全选择。
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