Miyazaki Haruna, Miura Daisuke, Koguchi Yukie, Takamatsu Chihiro, Sakaguchi Yoshiro
Department of Anesthesiology, Saga-Ken Medical Centre Koseikan, Saga, JPN.
Department of Anesthesiology, School of Medicine, Saga University, Saga, JPN.
Cureus. 2022 May 4;14(5):e24727. doi: 10.7759/cureus.24727. eCollection 2022 May.
Pheochromocytoma has a significant effect on perioperative hemodynamics; however, little is known about the changes caused by pheochromocytoma in pregnant women during cesarean delivery. Moreover, cesarean delivery in pregnant women with pheochromocytoma is often performed, along with pheochromocytoma removal, under general anesthesia depending on the time of delivery. Therefore, changes in the hemodynamics of these patients during cesarean delivery under spinal anesthesia combined with epidural anesthesia, along with their serum catecholamine concentration, have not been reported. In this report, we describe the changes in the maternal intraoperative hemodynamics and serum catecholamine level of a pregnant woman with pheochromocytoma who underwent cesarean delivery under combined spinal-epidural anesthesia at 35 weeks of gestation. No significant change in the hemodynamics and serum catecholamine level was observed, and the procedure was carried out safely. Cesarean delivery in an optimized pheochromocytoma patient under combined spinal-epidural anesthesia might be feasible without concurrent surgical removal of pheochromocytoma.
嗜铬细胞瘤对围手术期血流动力学有显著影响;然而,关于剖宫产期间嗜铬细胞瘤对孕妇血流动力学变化的影响却知之甚少。此外,患有嗜铬细胞瘤的孕妇通常会根据分娩时间,在全身麻醉下进行剖宫产并同时切除嗜铬细胞瘤。因此,尚未有关于这些患者在腰麻联合硬膜外麻醉下剖宫产期间血流动力学变化及其血清儿茶酚胺浓度的报道。在本报告中,我们描述了一名患有嗜铬细胞瘤的孕妇在妊娠35周时接受腰麻联合硬膜外麻醉下剖宫产时,其术中母体血流动力学和血清儿茶酚胺水平的变化。未观察到血流动力学和血清儿茶酚胺水平有显著变化,手术过程顺利。在优化的嗜铬细胞瘤患者中,腰麻联合硬膜外麻醉下进行剖宫产可能可行,而无需同时手术切除嗜铬细胞瘤。