Villa Dominic D, Suarez Christine Grace A, Nuñez Jeffrey Paolo M
Department of Anesthesiology, College of Medicine and Philippine General Hospital, University of the Philippines Manila.
Acta Med Philipp. 2024 May 23;58(9):54-58. doi: 10.47895/amp.v58i9.8779. eCollection 2024.
Parturients with both ankylosing spondylitis (AS) and SARS-CoV-2 Infection (COVID-19) present unique challenges to anesthesiologists. Neuraxial analgesia for labor remains the gold standard in obstetric patients. However, in patients with AS, this approach may be deemed difficult to impossible. Administration of systemic opioids for labor analgesia can be an option, bearing in mind the potential respiratory depressant effect to both the mother and the fetus, especially in the setting of concomitant COVID-19. This paper reports the successful management of such a patient using patient-controlled analgesia (PCA) with intravenous remifentanil.
患有强直性脊柱炎（AS）和严重急性呼吸综合征冠状病毒2感染（COVID-19）的产妇给麻醉医生带来了独特的挑战。分娩时的椎管内镇痛仍然是产科患者的金标准。然而，对于强直性脊柱炎患者，这种方法可能被认为困难甚至不可行。考虑到对母亲和胎儿都有潜在的呼吸抑制作用，尤其是在合并COVID-19的情况下，使用全身性阿片类药物进行分娩镇痛可以作为一种选择。本文报道了一名此类患者使用静脉注射瑞芬太尼自控镇痛（PCA）的成功管理案例。
