Clifford Sean Patrick, Mick Paul Brian, Derhake Brian Matthew
University of Louisville Hospital, Louisville, KY, USA.
Deaconess Hospital, Evansville, IN, USA.
J Investig Med High Impact Case Rep. 2016 Dec 1;4(4):2324709616683725. doi: 10.1177/2324709616683725. eCollection 2016 Oct-Dec.
Takayasu's arteritis is a rare, progressive panendarteritis involving all layers of the arterial wall. This disease includes variable involvement of the aorta and its major branches. The most common complication with this condition is severe, uncontrolled hypertension, often leading to end organ dysfunction. We describe the management of a 27-year-old woman diagnosed with Takayasu's arteritis that presented in labor with intense pain and underwent a combined spinal-epidural for anesthetic management. Per literature review, a combined spinal-epidural technique for planned vaginal delivery has not been described for a laboring Takayasu patient. Our technique, utilizing intrathecal opioids and a low-dose local anesthetic-opioid epidural infusion, provided adequate analgesia while maintaining hemodynamic stability throughout labor augmentation and successful vaginal delivery.
高安动脉炎是一种罕见的、进行性的全动脉炎，累及动脉壁的所有层次。这种疾病包括主动脉及其主要分支的不同程度受累。这种病症最常见的并发症是严重的、难以控制的高血压，常导致终末器官功能障碍。我们描述了一名27岁诊断为高安动脉炎的女性患者的处理情况，该患者分娩时剧痛，接受了腰麻-硬膜外联合麻醉管理。经文献检索，尚未有针对分娩期高安动脉炎患者计划经阴道分娩采用腰麻-硬膜外联合技术的描述。我们的技术采用鞘内注射阿片类药物和低剂量局部麻醉药-阿片类药物硬膜外输注，在整个产程加强及成功经阴道分娩过程中维持血流动力学稳定的同时提供了充分的镇痛效果。
