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两例升主动脉瘤产妇剖宫产的麻醉管理:病例讨论。

Anesthetic management for cesarean section in two parturient with ascending aortic aneurysm: a case-based discussion.

机构信息

Department of Anesthesiology, Perioperative Management and Intensive Care in Gynecology and Obstetrics, Clinic of Anesthesiology, Reanimatology, Intensive Care and Pain Therapy, University Clinical Hospital Centre Zagreb, Kišpatićeva 12, Zagreb, 10000, Croatia.

Department of Anesthesiology and Intensive Care in Cardiac and Vascular Surgery, Clinic of Anesthesiology, Reanimatology, Intensive Care and Pain Therapy, University Clinical Hospital Centre Zagreb, Kišpatićeva 12, Zagreb, 10000, Croatia.

出版信息

BMC Anesthesiol. 2024 May 6;24(1):169. doi: 10.1186/s12871-024-02553-2.

Abstract

BACKGROUND

The anesthetic management of parturients with ascending aortic aneurysm for cesarean section can be particularly challenging, primarily because of increased risk for aortic dissection or aneurysm rupture.

CASE PRESENTATION

We present some aspects of the anesthetic management of two parturients with ascending aortic aneurysm for cesarean sections; amongst, the use of remifentanil with its effects on patient and newborn. We emphasize the importance of a cardio-obstetric team in the context of preoperative planning of such patients. Also, we reviewed some literature on the anesthetic management with its effect on peri-operative hemodynamic stability.

CONCLUSION

Maintaining hemodynamic stability is paramount in the prevention of the rupture or dissection of ascending aortic aneurysm during labor of parturient.

摘要

背景

对于行剖宫产术的升主动脉瘤产妇,其麻醉管理极具挑战性,主要是因为主动脉夹层或瘤破裂的风险增加。

病例介绍

我们介绍了两名升主动脉瘤产妇行剖宫产术的麻醉管理的一些方面,包括瑞芬太尼的使用及其对产妇和新生儿的影响。我们强调了在这类患者的术前规划中组建心产科团队的重要性。此外,我们还回顾了一些关于麻醉管理及其对围手术期血流动力学稳定性影响的文献。

结论

在产妇分娩过程中,维持血流动力学稳定对于预防升主动脉瘤破裂或夹层至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bb4/11071247/f78e547b057d/12871_2024_2553_Fig1_HTML.jpg

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