Department of Anesthesiology and Pain Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea.
Int J Obstet Anesth. 2012 Apr;21(2):185-8. doi: 10.1016/j.ijoa.2011.12.008. Epub 2012 Feb 16.
Spontaneous spinal-epidural hematoma is uncommon and rare during pregnancy. We were presented with a 31-year-old patient who developed back pain with lower extremity paralysis at 36 weeks of gestation. A magnetic resonance imaging scan demonstrated an acute spinal-epidural hematoma and therefore, an emergency cesarean delivery was performed followed by hemilaminectomy with hematoma removal. Anesthesia was initiated with a volatile-based technique which, following delivery of the baby, was changed to target-controlled infusions of propofol and remifentanil. Postoperatively, dopamine was infused to maintain the blood pressure within the high-normal range to optimize spinal cord perfusion. Successful anesthetic and postoperative management is described together with a review of the literature.
自发性脊髓-硬膜外血肿在妊娠期间并不常见，也很少见。我们遇到一位 31 岁的患者，她在妊娠 36 周时出现背痛和下肢瘫痪。磁共振成像扫描显示急性脊髓-硬膜外血肿，因此进行了紧急剖宫产，随后进行了半椎板切除术和血肿清除术。麻醉采用挥发性技术开始，在分娩后改为丙泊酚和瑞芬太尼的靶控输注。术后给予多巴胺输注以维持血压在正常高值范围内，以优化脊髓灌注。本文描述了成功的麻醉和术后管理，并对文献进行了回顾。
