Handa F, Tanaka M, Toyooka H
Department of Anesthesia, University of Tsukuba.
Masui. 1997 Aug;46(8):1110-3.
We have retrospectively analyzed twelve pregnancies in nine patients with intracranial arteriovenous malformation (AVM) managed at our hospital from 1984 to 1995. Following radical excision of AVM before or during pregnancy in 6 cases, transvaginal deliveries were performed without untoward sequelae. In three of five patients who received non-curative treatments, labor analgesia was provided using epidural local anesthetics. One patient who presented with ruptured AVM followed by medical therapy, elective cesarean section was performed under spinal anesthesia with a favorable outcome. Anesthesia courses in two patients for the resection of ruptured AVM during pregnancy were uneventful under enflurane and nitrous oxide anesthesia, or balanced anesthesia using fentanyl and nitrous oxide in oxygen. Simultaneous cesarean section craniotomy was not performed at our hospital.
我们回顾性分析了1984年至1995年在我院接受治疗的9例颅内动静脉畸形（AVM）患者的12次妊娠情况。6例患者在妊娠前或妊娠期间接受了AVM根治性切除，经阴道分娩，未出现不良后果。在5例接受非根治性治疗的患者中，有3例使用硬膜外局部麻醉进行分娩镇痛。1例患者出现AVM破裂并接受药物治疗，在脊髓麻醉下行择期剖宫产，结果良好。2例患者在妊娠期间因切除破裂的AVM接受麻醉，在安氟醚和氧化亚氮麻醉下，或使用芬太尼和氧化亚氮在氧气中进行平衡麻醉，麻醉过程顺利。我院未进行同期剖宫产开颅手术。
