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剖宫产脊髓麻醉后心脏骤停:一例病例报告。

Cardiac arrest following spinal anaesthesia for caesarean section: a case report.

作者信息

Osazuwa M O, Edomwonyi N P

机构信息

Department of Anaesthesia, University of Benin Teaching Hospital, PMB 1111, Benin City, Edo State, Nigeria.

出版信息

West Afr J Med. 2012 Jul-Sep;31(3):207-10.

Abstract

Spinal anaesthesia is regarded safe for caesarean section. Serious complications resulting from spinal anaesthesia such as cardiac arrest are often times considered rare. This is a case of a 27-year old unbooked gravida1 who was scheduled for emergency caesarean section on account of cephalo-pelvic disproportion (CPD) with associated history of prolonged labour. The patient was preloaded with normal saline one hour before subarachnoid block (SAB) was established and suffered a cardiac arrest immediately after establishing SAB. She was successfully resuscitated using chest compressions, adrenaline and oxygen and a live baby was delivered during cardiopulmonary resuscitation (CPR). The patient developed seizures in the immediate postoperative period. She was treated with an anti-epileptic drug and was also mechanically ventilated. She also developed features of puerperal psychosis and was managed with anti-psychotics. The patient was on admission in the intensive care unit for four days and she made quick recovery with no apparent residual damage.

摘要

脊髓麻醉被认为对剖宫产是安全的。脊髓麻醉导致的严重并发症如心脏骤停通常被认为很罕见。这是一例27岁未预约的初产妇,因头盆不称(CPD)并伴有产程延长史而计划行急诊剖宫产。在蛛网膜下腔阻滞(SAB)建立前一小时,患者输注了生理盐水,在建立SAB后立即发生心脏骤停。通过胸外按压、肾上腺素和氧气成功复苏,并且在心肺复苏(CPR)期间娩出了一名活婴。患者在术后即刻出现癫痫发作。给予抗癫痫药物治疗并进行机械通气。她还出现了产褥期精神病的症状,接受了抗精神病药物治疗。患者在重症监护病房住院四天,恢复迅速,无明显残留损害。

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