Shin Y K, Kim Y D
Department of Anesthesia, Georgetown University School of Medicine, Washington, DC 20007.
South Med J. 1988 Apr;81(4):528-30. doi: 10.1097/00007611-198804000-00032.
This case illustrates that patients receiving ritodrine for preterm labor may risk interactions between the residual betamimetic effects of ritodrine and the effects of anesthetics during cesarean section. Such interactions may result in serious cardiovascular complications even after cessation of an infusion of ritodrine. Preoperative assessment should focus on cardiovascular status and serum potassium level. Delaying induction of anesthesia should be considered whenever possible. Careful fluid administration and cautious use of titrated doses of ephedrine are advised. After delivery of the infant, there should be no contraindication to the use of an alpha-adrenergic vasopressor such as phenylephrine to treat hypotensive patients with tachycardia.
该病例表明，接受利托君治疗早产的患者在剖宫产期间可能面临利托君残留拟交感神经效应与麻醉剂效应之间的相互作用风险。即使在停止输注利托君后，这种相互作用也可能导致严重的心血管并发症。术前评估应着重于心血管状况和血清钾水平。应尽可能考虑延迟麻醉诱导。建议谨慎输液并谨慎使用滴定剂量的麻黄碱。婴儿分娩后，对于使用去氧肾上腺素等α-肾上腺素能血管升压药治疗心动过速的低血压患者，应无禁忌。
