Cho Ana, So Jinyoung, Ko Eun Young, Choi Dasom
Department of Anesthesia & Pain Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Gyeonggi-do, Republic of Korea.
Medicine (Baltimore). 2020 Jul 31;99(31):e21435. doi: 10.1097/MD.0000000000021435.
The population of obese individuals is increasing worldwide, and as a result, the number of mothers with super morbid obesity undergoing cesarean sections is also increasing. However, little is known about which anesthetic technique is appropriate for cesarean sections of super morbidly obese parturients.
A 35-year-old woman with body mass index 61.3 kg/m at a gestational age of 37 weeks.
The patient was super morbidly obese parturient.
Spinal anesthesia was performed. A spinal needle was inserted into the L4-5 interspinous space in the sitting position. After confirmation of cerebrospinal fluid, 0.5% hyperbaric bupivacaine 9 mg and fentanyl 20 μg were injected into the subarachnoid space.
After the administration of spinal anesthetics, the nerve block to the T8 dermatome level was confirmed, surgery was performed, and the fetus was delivered. The patient's vital signs were stable until the end of the operation.
There is no established strategy for selecting a method of anesthesia in patients with morbid obesity (body mass index 40 kg/m or more). For this reason and considering the amount of bupivacaine used for spinal anesthesia, we wanted to share our experience with spinal anesthesia for cesarean section in a super morbidly obese parturients.
全球肥胖人群数量在不断增加，因此，接受剖宫产的超级病态肥胖母亲的数量也在增加。然而，对于哪种麻醉技术适用于超级病态肥胖产妇的剖宫产手术，人们了解甚少。
一名35岁女性，孕37周时体重指数为61.3kg/m²。
该患者为超级病态肥胖产妇。
实施脊髓麻醉。患者取坐位，将脊髓穿刺针插入L4-5棘突间隙。确认脑脊液后，将0.5%的重比重布比卡因9mg和芬太尼20μg注入蛛网膜下腔。
给予脊髓麻醉后，确认神经阻滞平面达T8皮节水平，进行了手术并娩出胎儿。患者生命体征直至手术结束一直保持稳定。
对于病态肥胖（体重指数40kg/m²及以上）患者，尚无确定的麻醉方法选择策略。基于此，并考虑到脊髓麻醉所用布比卡因的剂量，我们希望分享我们在超级病态肥胖产妇剖宫产脊髓麻醉方面的经验。
