Department of Anaesthetics, Ipswich Hospital NHS Trust, Heath Road, Ipswich, UK.
Int J Obstet Anesth. 2013 Nov;22(4):337-9. doi: 10.1016/j.ijoa.2013.06.001. Epub 2013 Aug 19.
Neuraxial anaesthetic techniques are considered useful to minimise haemodynamic stress during labour. In Marfan's syndrome, connective tissue abnormalities not only affect the thoracic aorta but also predispose to dural ectasia. A dural ectatic sac may cause difficulties with neuraxial analgesia and anaesthesia. We discuss magnetic resonance imaging appearances and anaesthetic experience of three deliveries in a parturient with stable echocardiographic findings. We consider that epidural analgesia and anaesthesia are a safe and pragmatic solution for labour and delivery. Lumbo-sacral magnetic resonance imaging at presentation will define dural ectasia and assist in management.
神经轴麻醉技术被认为可有效减少分娩过程中的血液动力学应激。在马凡综合征中,结缔组织异常不仅影响胸主动脉,而且易导致硬脊膜扩张。硬脊膜扩张囊可导致神经轴镇痛和麻醉困难。我们讨论了一位超声心动图结果稳定的产妇的三次分娩的磁共振成像表现和麻醉经验。我们认为硬膜外镇痛和麻醉是分娩的安全且实用的解决方案。就诊时的腰骶磁共振成像将明确硬脊膜扩张并有助于管理。