Department of Anesthesiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China.
Medicine (Baltimore). 2021 Oct 29;100(43):e27621. doi: 10.1097/MD.0000000000027621.
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with the fatal course of muscle weakness. The published experience of anesthesia management in the cesarean section with ALS parturient is scant.
A 34-year-old woman was admitted to our center complaining of obvious dysphagia together with atrophy and weakness of quadriceps at 24 weeks of her pregnancy. Cesarean was planned at 36 weeks' gestation due to the rapid deterioration of the mother.
The results of neurological examination, electromyography and spinal magnetic resonance imaging suggested ALS according to the EI Escorial World Federation of Neurology criteria.
Ultrasound-guided transversus abdominis plane block with 0.6 minimum alveolar concentration sevoflurane was used in this ALS parturient during her cesarean section procedure.
This anesthesia strategy successfully met the demands of the surgery, helped avoid prolonged ventilation and prevent maternal respiratory complications.
Transversus abdominis plane block with subanesthetic concentrations of sevoflurane can provide effective and safe anesthesia in the cesarean section for a patient with ALS.
肌萎缩侧索硬化症（ALS）是一种进行性神经退行性疾病，其肌肉无力的病程是致命的。发表的关于 ALS 产妇剖宫产麻醉管理的经验很少。
一名 34 岁女性因怀孕 24 周时出现明显吞咽困难，同时股四头肌萎缩和无力而到我院就诊。由于母亲病情迅速恶化，计划在 36 周时行剖宫产术。
根据 EI Escorial 世界神经病学联合会标准，神经科检查、肌电图和脊髓磁共振成像结果提示 ALS。
在该 ALS 产妇的剖宫产手术中，使用超声引导下腹横肌平面阻滞，七氟醚最低肺泡浓度为 0.6。
这种麻醉策略成功满足了手术需求，有助于避免长时间通气和预防产妇呼吸并发症。
亚麻醉浓度七氟醚的腹横肌平面阻滞可在 ALS 产妇的剖宫产术中提供有效且安全的麻醉。
