Bader A M, Camann W R, Datta S
Department of Anesthesia, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts.
Reg Anesth. 1990 Sep-Oct;15(5):261-3.
Some concerns exist regarding the use of regional anesthesia for patients with active genital herpes simplex virus type-2 (HSV) infections undergoing cesarean delivery. Previous studies have reported the safe use of epidural anesthesia in these patients; there are no reports of the use of spinal anesthesia in this setting. We performed a 6-year retrospective survey of 169 patients delivered by cesarean delivery because of HSV infection. One hundred sixty-four of these patients had the diagnosis of secondary infection and five had the diagnosis of primary infection. Fifty-nine patients received general anesthesia, 75 received spinal anesthesia, and 35 received epidural anesthesia. One patient who was diagnosed with primary herpes and who received spinal anesthesia had a transient postpartum neurologic deficit; the etiology of this deficit was not clearly related to the anesthetic technique. No patients with secondary infection had septic or neurologic complications related to the anesthetic. Both spinal and epidural anesthesia appear to be safe alternatives for patients with secondary HSV infections undergoing cesarean delivery.
对于正在接受剖宫产的活动性2型单纯疱疹病毒（HSV）感染患者使用区域麻醉存在一些担忧。既往研究报道了在这些患者中安全使用硬膜外麻醉；尚无在这种情况下使用脊髓麻醉的报道。我们对169例因HSV感染而行剖宫产的患者进行了为期6年的回顾性调查。这些患者中164例诊断为继发感染，5例诊断为原发感染。59例患者接受全身麻醉，75例接受脊髓麻醉，35例接受硬膜外麻醉。1例诊断为原发性疱疹且接受脊髓麻醉的患者出现了短暂的产后神经功能缺损；该缺损的病因与麻醉技术无明显关联。继发感染的患者中没有出现与麻醉相关的败血症或神经并发症。对于接受剖宫产的继发HSV感染患者，脊髓麻醉和硬膜外麻醉似乎都是安全的选择。
