Sato Seiko, Nakamori Erisa, Kusumoto Go, Shigematsu Kenji, Yamaura Ken
From the *Department of Anesthesiology, Fukuoka University Hospital, Fukuoka, Japan; and †Operating Rooms, Fukuoka University Hospital, Fukuoka, Japan.
A A Case Rep. 2017 Mar 1;8(5):96-99. doi: 10.1213/XAA.0000000000000440.
A 28-year-old woman with preeclampsia at 32 weeks of gestation underwent a cesarean delivery under spinal anesthesia. Administration of nitroglycerin at 200 μg to relax uterine smooth muscles and the application of fundal pressure led to severe bradycardia and loss of consciousness, followed by cardiac arrest. Delivery was completed immediately and recovery was achieved 10 seconds later following cardiopulmonary resuscitation. Neurally mediated syncope was considered the cause of cardiac arrest. Anesthetists should be aware of the potential risk during cesarean delivery following the administration of nitroglycerin, fundal pressure, regional anesthesia, and hypovolemia because of preeclampsia.
一名28岁妊娠32周的子痫前期妇女在脊髓麻醉下接受剖宫产。给予200μg硝酸甘油以松弛子宫平滑肌并施加宫底压力后，出现严重心动过缓和意识丧失，随后心脏骤停。立即完成分娩，心肺复苏10秒后恢复。神经介导的晕厥被认为是心脏骤停的原因。麻醉医生应意识到，由于子痫前期，在剖宫产过程中使用硝酸甘油、施加宫底压力、区域麻醉和血容量不足时存在潜在风险。
