Narasimha Prasad Krishnamurthy, Chaudhuri Souvik, Joseph Tim Thomas
Department of Anaesthesiology, Kasturba Medical College, Manipal, Karnataka, India.
Indian J Anaesth. 2013 Jan;57(1):66-8. doi: 10.4103/0019-5049.108571.
Takayasu's arteritis (TA) is rare, chronic progressive, pan-endarteritis involving the aorta and its main branches, with a specific predilection for young Asian women. Anaesthesia for TA patients is complicated by their severe uncontrolled hypertension, extreme arterial blood pressure differentials, aortic regurgitation (AR), end-organ dysfunction, stenosis/aneurysms of major blood vessels and difficulties encountered in monitoring arterial blood pressure. We present the usefulness of ultrasound during anaesthetic management of a 35-year-old woman posted for emergency caesarean section due to intra-uterine growth retardation, foetal tachycardia in active labour, who was already diagnosed to have TA along with moderate AR and uncontrolled hypertension, using epidural technique. The use of intra-operative doppler helped resolve the initial dilemma about the diagnosis and treatment of the differential blood pressure between the affected and the normal upper limb in the absence of prior arteriogram.
高安动脉炎（TA）较为罕见，是一种慢性进行性全动脉炎，累及主动脉及其主要分支，特别好发于年轻亚洲女性。TA患者的麻醉会因严重的血压控制不佳、动脉血压差异极大、主动脉反流（AR）、终末器官功能障碍、主要血管狭窄/动脉瘤以及动脉血压监测困难而变得复杂。我们介绍了超声在一名35岁女性麻醉管理中的应用，该女性因胎儿宫内生长受限、活跃期宫缩时胎儿心动过速，行急诊剖宫产术，她已被诊断患有TA，伴有中度AR和血压控制不佳，采用硬膜外技术。术中使用多普勒有助于解决在未进行动脉造影的情况下，关于患侧上肢与正常上肢血压差异的诊断和治疗的最初困境。
