Dresner M R, Maclean A R
Department of Anaesthesia, St James's University Hospital, Leeds.
Anaesthesia. 1995 Sep;50(9):807-9. doi: 10.1111/j.1365-2044.1995.tb06146.x.
A 34-year-old woman with severe kyphoscoliosis, an immobile cervical spine, and short stature due to the Klippel-Feil syndrome presented for elective Caesarean section. She expressed a strong desire to remain awake during the procedure. We chose a technique using a spinal microcatheter to provide spinal anaesthesia on the basis that incremental control of the dose of bupivacaine would reduce the risk of 'high' block. Awake inspection of the larynx was performed as a precaution in the event of respiratory embarrassment. A total of 6.25 mg heavy bupivacaine, 7.5 mg plain bupivacaine, and 10 micrograms fentanyl were administered over 20 min. This provided anaesthesia up to T5 without significant effects on respiratory or cardiovascular function. The patient was successfully delivered of a healthy boy.
一名34岁女性因克利珀尔-费尔综合征患有严重脊柱后侧凸、颈椎固定不动且身材矮小，前来接受择期剖宫产手术。她强烈希望在手术过程中保持清醒。基于可逐步控制布比卡因剂量以降低“高位”阻滞风险的考虑，我们选择了使用脊髓微导管进行脊髓麻醉的技术。作为预防措施，在出现呼吸窘迫时对喉部进行清醒检查。在20分钟内共给予6.25毫克重比重布比卡因、7.5毫克普通布比卡因和10微克芬太尼。这提供了高达T5水平的麻醉效果，且对呼吸或心血管功能无明显影响。该患者成功产下一名健康男婴。
