格林-巴利综合征患者剖宫产的麻醉：病例报告

Anesthesia for cesarean section in a patient with Guillain-Barre syndrome: Case report.

作者信息

Volquind Daniel, Fellini Roberto Taboada, Rose Giana Lucho, Tarso Gabriel Pedro

机构信息

Title in Anesthesiology (TSA); Professor of the Universidade de Caxias do Sul; Anesthesiologist of the CAN-Clínica de Anestesiologia de Caxias do Sul, RS, Brazil.

Anesthesiologist of the CAN-Clínica de Anestesiologia de Caxias do Sul, RS, Brazil.

出版信息

Braz J Anesthesiol. 2013 Jul-Aug;63(4):369-71. doi: 10.1016/j.bjane.2012.06.002. Epub 2013 Aug 13.

DOI:10.1016/j.bjane.2012.06.002

PMID:24565247

Abstract

BACKGROUND AND OBJECTIVES

Guillain-Barre syndrome during pregnancy is considered a rare neurological complication, and there is no consensus in literature for anesthetic management for cesarean section in such patients. The objective of this paper is to report the case of a pregnant woman with Guillain-Barre syndrome undergoing cesarean section.

CASE REPORT

Female patient, 22-year old, 35 weeks and 5 days of gestation, undergoing cesarean section, hospitalized, reporting decreased strength and lower limb paresthesias. Cerebrospinal fluid (CSF) analysis showed increased protein (304 mg.dL(-1)) without increased cellularity. The anesthetic technique used was general anesthesia induced with propofol (1.5 mg.kg(-1)) and maintained with 2% sevoflurane in oxygen and fentanyl (3 μg.kg(-1)). The procedure was uneventful for both mother and neonate. The patient was discharged 10 days after admission, after progressive improvement of neurological symptoms.

CONCLUSION

The anesthetic technique for pregnant women with Guillain-Barre syndrome requiring cesarean section remains at the discretion of the anesthesiologist, who should be guided by the clinical conditions and comorbidities of each patient.

摘要

背景与目的

妊娠期格林-巴利综合征被认为是一种罕见的神经系统并发症，对于此类患者剖宫产的麻醉管理，文献中尚无共识。本文的目的是报告一例患有格林-巴利综合征的孕妇接受剖宫产的病例。

病例报告

女性患者，22岁，妊娠35周零5天，因剖宫产入院，自述肌力下降及下肢感觉异常。脑脊液（CSF）分析显示蛋白升高（304mg·dL⁻¹），细胞数未增加。麻醉技术采用丙泊酚（1.5mg·kg⁻¹）诱导全身麻醉，并用2%七氟醚加氧气及芬太尼（3μg·kg⁻¹）维持。手术过程中母婴均平安。入院10天后，患者神经症状逐渐改善，随后出院。