Bansal Vikash, Saxena Kirti N, Wadhwa Bharti
Department of Anaesthesiology and Critical Care, Maulana Azad Medical College, New Delhi, India.
Saudi J Anaesth. 2023 Jan-Mar;17(1):107-109. doi: 10.4103/sja.sja_461_22. Epub 2023 Jan 2.
A 21-year-old female was scheduled to undergo elective cesarean section for breech presentation under the subarachnoid block (SAB). The pre-operative examination was unremarkable and baseline vitals were normal. Under all aseptic precautions and American society of anesthesiologists standard monitoring, SAB was administered with 2.2 ml of 0.5% hyperbaric bupivacaine. Soon after administration of SAB, prophylactic infusion of phenylephrine was started at the rate of 50 μg/min; after pre-treatment with 0.2 mg glycopyrrolate intravenous immediately after the start of the infusion, the patient complained of severe headache. Blood pressure (BP) recorded at that time was 191/102 mm of Hg. Phenylephrine infusion was stopped immediately but the BP remained high and came to within 20% of baseline value only after 9 min of discontinuing the infusion. We report this case of refractory hypertension following phenylephrine infusion in a healthy parturient undergoing elective cesarean section under SAB.
一名21岁女性计划在蛛网膜下腔阻滞（SAB）下因臀位行择期剖宫产术。术前检查无异常，基线生命体征正常。在所有无菌预防措施和美国麻醉医师协会标准监测下，给予2.2毫升0.5%的重比重布比卡因进行蛛网膜下腔阻滞。蛛网膜下腔阻滞给药后不久，开始以50微克/分钟的速率预防性输注去氧肾上腺素；在输注开始后立即静脉注射0.2毫克格隆溴铵进行预处理后，患者主诉严重头痛。当时记录的血压（BP）为191/102毫米汞柱。立即停止输注去氧肾上腺素，但血压仍居高不下，仅在停止输注9分钟后才降至基线值的20%以内。我们报告了这例在接受蛛网膜下腔阻滞的择期剖宫产术的健康产妇中输注去氧肾上腺素后出现难治性高血压的病例。
