Drexel University College of Medicine/ Hahnemann University Hospital, Department of Anesthesiology and Perioperative Medicine, Philadelphia, USA; LPG /Rhode Island Hospital, Department of Anesthesiology, Providence, USA.
Drexel University College of Medicine/ Hahnemann University Hospital, Department of Anesthesiology and Perioperative Medicine, Philadelphia, USA; NYU Langone Health, Department of Anesthesiology, New York, USA.
Braz J Anesthesiol. 2021 May-Jun;71(3):278-280. doi: 10.1016/j.bjane.2020.10.011. Epub 2021 Feb 3.
Neuraxial anesthesia is a standard of care during parturition. Since bleeding diathesis is a contraindication to neuraxial techniques, data about its safe administration in a thrombocytopenic milieu is limited and evolving. Thrombocytopenia associated with preeclampsia or eclampsia and hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome leads to significant maternal and neonatal morbidity. We present a case of uneventful spinal anesthesia for urgent cesarean section in an eclamptic patient with a precipitous drop in platelet count from 124,000 to 97,000 per cubic millimeter under thromboelastography (TEG) guidance.
椎管内麻醉是分娩过程中的标准护理。由于出血素质是椎管内技术的禁忌症，因此关于在血小板减少环境中安全管理的相关数据有限且不断发展。与子痫前期或子痫以及溶血、肝酶升高和血小板计数降低（HELLP）综合征相关的血小板减少症会导致产妇和新生儿发病率显著增加。我们报告了一例在血小板计数从每立方毫米 124,000 急剧下降至 97,000 的情况下，在血栓弹力图（TEG）引导下，对一名子痫患者进行紧急剖宫产的椎管内麻醉的无并发症病例。
