Kanmura Y, Hagihira Y, Higashi M, Yamashita K, Sameshima K, Toda H, Yoshimura N
Department of Anesthesiology, Kagoshima City Hospital.
Masui. 1995 Mar 3;44(3):407-10.
We report the anesthetic management of Cesarean section in a pregnant (31 weeks) woman with dilated cardiomyopathy. She had dyspnea and chest pain which were signs of congestive heart failure. The left ventricular ejection fraction was 38%. Anesthesia was induced and maintained with fentanyl, midazolam and vecuronium. There was no significant cardiovascular changes in the mother during the operation. The baby was apneic and showed no movement at birth, but he was immediately intubated and his condition became almost normal on the following day. In the anesthesiological management of Cesarean sections with cardiac disease, general anesthesia with fentanyl can be used to minimize cardiovascular changes in the mother as long as the baby is immediately resuscitated after delivery.
我们报告了一名患有扩张型心肌病的31周孕妇剖宫产的麻醉管理情况。她有呼吸困难和胸痛,这些是充血性心力衰竭的症状。左心室射血分数为38%。采用芬太尼、咪达唑仑和维库溴铵诱导并维持麻醉。手术过程中母亲的心血管系统没有明显变化。婴儿出生时无呼吸且无活动,但立即进行了气管插管,第二天情况基本恢复正常。在患有心脏病的剖宫产麻醉管理中,只要婴儿在分娩后立即进行复苏,使用芬太尼进行全身麻醉可将母亲的心血管变化降至最低。