Ando Akira, Hishinuma Norimasa, Shirotori Toru, Sasao Junichi, Tanaka Satoshi, Kawamata Mikito
Masui. 2014 Jun;63(6):686-8.
A 27-year-old parturient (height, 130 cm; weight, 43 kg) with achondroplasia, which is characterized by rhizomeric short stature, large head and frontal bossing, was scheduled for elective caesarean section (C/S) because of her contracted pelvis. Her first delivery had been performed by C/S under general anesthesia at a regional hospital 6 years before. Preoperative airway assessment showed normal mouth opening and mobile cervical spine. Since she had anxiety about needle puncture and refused neuraxial blockade and since we considered the trachea could be intubated, we decided to perform C/S under general anesthesia at 37 weeks of gestation. The patient and baby had an uneventful perioperative course. Underdevelopment of bone formation results in characteristic craniofacial and vertebral abnormalities in patients with achondroplasia. Anesthetic management of achondroplastic parturients should be specified to individual basis based on careful preoperative assessment of craniofacial and vertebral deformities.
一名27岁的产妇（身高130厘米，体重43千克），患有软骨发育不全，其特征为肢体短小、头部大且额部突出，因骨盆狭窄计划行择期剖宫产术。她的第一次分娩是6年前在一家地区医院在全身麻醉下进行的剖宫产。术前气道评估显示张口正常，颈椎活动度正常。由于她对针刺感到焦虑，拒绝神经轴阻滞，且我们认为可以进行气管插管，因此决定在妊娠37周时在全身麻醉下进行剖宫产。患者和婴儿围手术期过程顺利。骨形成发育不全导致软骨发育不全患者出现典型的颅面和脊柱异常。对于软骨发育不全的产妇，应在仔细术前评估颅面和脊柱畸形的基础上，根据个体情况制定麻醉管理方案。
