Podder Subrata, Kumar Ajay, Mahajan Sachin, Saha Pradip Kumar
Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Ann Card Anaesth. 2015 Jan-Mar;18(1):98-100. doi: 10.4103/0971-9784.148330.
Pregnancy in presence of severe aortic stenosis (AS) causes worsening of symptoms needing further intervention. In the advanced stages of pregnancy, some patients may even require aortic valve replacement (AVR) and cesarean delivery in the same sitting. Opioid based general anesthesia for combined lower segment cesarean section (LSCS) with AVR has been described. However, the use of opioid may lead to fetal morbidity and need of respiratory support for the baby. We describe successful anesthetic management for LSCS with AVR in a >33 week gravida with severe AS and congestive heart failure. We avoided opioids till delivery of the baby AVR; the delivered neonate showed a normal APGAR score.
重度主动脉瓣狭窄（AS）患者怀孕会导致症状恶化，需要进一步干预。在妊娠晚期，一些患者甚至可能需要在同一次手术中进行主动脉瓣置换（AVR）和剖宫产。已有文献报道在低位剖宫产术（LSCS）联合AVR时使用基于阿片类药物的全身麻醉。然而，使用阿片类药物可能会导致胎儿发病，并需要对婴儿进行呼吸支持。我们描述了一名孕周>33周、患有重度AS和充血性心力衰竭的孕妇在LSCS联合AVR手术中成功的麻醉管理。在婴儿娩出并完成AVR之前，我们避免使用阿片类药物；娩出的新生儿阿氏评分正常。
