Oouchi Sueko, Nagata Hirofumi, Ookawa Haruo, Oikawa Tomoko, Iwabuchi Yoko, Suzuki Kenji S
Department of Anesthesiology, School of Medicine, Iwate Medical University, Morioka 020-8505.
Masui. 2013 Apr;62(4):474-6.
Spinal anesthesia is thought to be contraindicated for patients with multiple sclerosis (MS). We describe the case of a patient with MS who was administered spinal anesthesia for cesarean section. A 29-year-old woman (weight 55.8 kg, height 154 cm) with MS underwent an urgent cesarean section in the 39th week of her pregnancy for fetal malpresentation. Although the patient had experienced repeated relapses of MS thrice since she was 19, she had remained in remission since the age of 27, and did not have significant neurological disability. A 27 G needle (pencil type) was used for arachnoid puncture, and 0.5% hyperbaric bupivacaine (2.0 ml) was administered to the subarachnoid space at the L3-4 interspace. After confirming that the sensory blockade after spinal anesthesia had spread to T4, cesarean section was performed. For the subsequent 19 months, no remission of MS was recognized. Thus, spinal anesthesia does not seem to be contraindicated for patients with MS in remission state.
脊髓麻醉被认为对患有多发性硬化症（MS）的患者是禁忌的。我们描述了一名患有MS的患者在剖宫产时接受脊髓麻醉的病例。一名29岁女性（体重55.8kg，身高154cm），患有MS，因胎儿胎位不正，在妊娠第39周接受了紧急剖宫产。尽管该患者自19岁起经历了三次MS复发，但自27岁起一直处于缓解期，且没有明显的神经功能障碍。使用27G铅笔型针进行蛛网膜穿刺，并在L3 - 4间隙将0.5%的高压布比卡因（2.0ml）注入蛛网膜下腔。确认脊髓麻醉后的感觉阻滞范围已扩散至T4后，进行了剖宫产。在随后的19个月里，未发现MS复发。因此，对于处于缓解期的MS患者，脊髓麻醉似乎并非禁忌。
