对于一名患有累及颈髓交界处的大型动静脉畸形且处于活跃期分娩的患者，急诊剖宫产的全身麻醉替代方案。
Alternative to General Anesthesia for a Stat Cesarean Delivery in a Patient with a Large Arteriovenous Malformation Involving the Cervicomedullary Junction in Active Labor.
作者信息
Santos Christiano Dos Santos E, Joyner David A, Tuma Santos Cristiane A, Grayson Bernadette E, Calimaran Arthur, Bacon Douglas R
机构信息
Department of Anesthesiology, University of Mississippi Medical Center, Jackson, MS, USA.
Department of Radiology, University of Mississippi Medical Center, Jackson, MS, USA.
出版信息
Case Rep Anesthesiol. 2020 Feb 13;2020:6893587. doi: 10.1155/2020/6893587. eCollection 2020.
A 20-year-old G1P0 patient at 38 weeks and 1 day of gestation was admitted for emergency cesarean delivery. Her past medical history was positive for cervicomedullary arteriovenous malformation (AVM) that ruptured three years before. Spontaneous vaginal delivery was contraindicated by neurosurgery. Aiming for cardiovascular stability and immediate reduction of sympathetic activity, a combined spinal epidural was successfully placed. An uneventful cesarean section was performed. The patient was transferred to the intensive care unit neurologically intact and discharged home after 8 days. This report describes an unusual anesthetic management of a patient with a large AVM in active labor.
一名孕38周零1天的20岁初产妇因紧急剖宫产入院。她既往有颈髓动静脉畸形（AVM）病史，三年前曾破裂出血。神经外科医生认为自然阴道分娩存在禁忌。为了维持心血管稳定并立即降低交感神经活性，成功实施了腰麻-硬膜外联合麻醉。剖宫产手术顺利完成。患者被转至重症监护病房，神经系统功能完好，8天后出院。本报告描述了一名患有大型动静脉畸形且处于活跃分娩期患者的特殊麻醉管理情况。
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