[Anesthetic management for cesarean section and clipping of aneurysm in a pregnant woman with ruptured cerebral aneurysm].

We report an anesthetic management for Cesarean section and clipping of aneurysm in a pregnant woman with a subarachnoidal hemorrhage secondary to a ruptured cerebral aneurysm. Anesthesia was induced with thiopental, vecuronium and sevoflurane, and maintained with sevoflurane (0.5-1%) before the delivery. Apgar score at 1 min was 1, but after 30 min her activity became almost normal. After the delivery, anesthesia was maintained with fentanyl for clipping surgery, because sevoflurane may inhibit uterine contraction and increase bleeding from the uterus after the delivery. We also infused prostaglandin E1 continuously at a rate of 50-70 ng.kg-1.min-1 to control arterial blood pressure and to maintain good contraction of the uterus during clipping surgery. We conclude that prostaglandin E1 is useful as a vasodilator after delivery because prostaglandin E1 contracts the uterus.