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重度肥厚型梗阻性心肌病合并支气管哮喘患者急诊剖宫产的麻醉管理

Anaesthetic management of severe hypertrophic obstructive cardiomyopathy with bronchial asthma for emergency caesarean section.

作者信息

Rajesh M C, Varma Ravi, Lima P, Ramdas E K

机构信息

Department of Anaesthesiology, Pain and Peri-operative Medicine, Baby Memorial Hospital, Calicut 673004.

出版信息

J Indian Med Assoc. 2012 Oct;110(10):745-6, 748.

Abstract

A 39-year-old primi and a known case of hypertrophic obstructive cardiomyopathy presented for emergency lower segment caesarean section. She was also an asthmatic with a recent exacerbation. She underwent uneventful lower segment caesarean section under general anaesthesia with lumbar epidural analgesia for postoperative pain relief. Anaesthetic agents and techniques were selected to suit the haemodynamic profile of severe hypertrophic obstructive cardiomyopathy in pregnancy. The case has been reported because of successful outcome in an emergency scenario with such high intraventricular gradients and omissions in the case so that it will be of benefit to readers who may happen to land up in similar situations.

摘要

一名39岁初产妇,已知患有肥厚性梗阻性心肌病,因紧急行下段剖宫产入院。她也是一名哮喘患者,近期病情加重。她在全身麻醉联合腰段硬膜外镇痛以缓解术后疼痛的情况下,顺利进行了下段下段剖宫产。选择麻醉药物和技术以适应妊娠期严重肥厚性梗阻性心肌病的血流动力学特征。报告该病例是因为在这种具有如此高心室梯度的紧急情况下取得了成功结果,以及该病例中的一些遗漏情况,以便可能遇到类似情况的读者能从中受益。

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