A Case Report of Spinal Anesthesia for Cerclage Placement in the Setting of Severe Hypertrophic Obstructive Cardiomyopathy.

IF 0.5

A&A Practice Pub Date : 2023-04-01 DOI:10.1213/XAA.0000000000001675

Patrick T Hussey, Hanna Hussey, Jamal Egbaria, Ruth Landau, Matthew M Townsley

引用次数: 0

Abstract

Neuraxial anesthesia is preferred over general anesthesia in obstetric patients to avoid airway manipulation, aspiration, and maternal-fetal transfer of medications; however, a sudden sympathetic block is generally avoided in patients with hypertrophic obstructive cardiomyopathy (HOCM). The case of a 31-year-old G2P0010 with HOCM with severe resting left ventricular outflow tract (LVOT) obstruction and systolic anterior motion of the mitral valve undergoing a cerclage under choroprocaine spinal anesthesia is presented. Risks and benefits of general versus neuraxial anesthesia, and epidural versus spinal anesthesia, in this specific setting are reviewed.

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重度肥厚性梗阻性心肌病脊髓麻醉环扎术1例报告。

在产科患者中，为了避免气道操作、误吸和母婴药物转移，首选轴向麻醉而非全身麻醉;然而，肥厚性梗阻性心肌病(HOCM)患者通常避免突然交感神经阻滞。病例31岁G2P0010 HOCM严重静息左心室流出道(LVOT)阻塞和二尖瓣收缩期前运动在氯普鲁卡因脊髓麻醉下行环扎术。在这种特殊情况下，对全身麻醉与神经轴麻醉、硬膜外麻醉与脊髓麻醉的风险和益处进行综述。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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A&A Practice ANESTHESIOLOGY-

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期刊介绍： A & A Case Reports, our new online journal publishing Case Reports, related Editorial Commentary, and Correspondence. Anesthesia & Analgesia 1 and Anesthesiology 2 recently announced that they were suspending publication of Case Reports. One reason is that Case Reports typically reduce the Impact Factor of a journal because they are rarely cited. Regardless of the merits of Impact Factor as a metric of journal worth, journals and their editors necessarily consider Impact Factor in strategic planning. At the same time, Case Reports are appreciated by readers for describing “real life” management of difficult or unusual cases not often encountered by practitioners. In a recent issue of Anesthesia & Analgesia, Steven Shafer1 identified many Case Reports whose publication launched productive careers dedicated to solving the puzzle posed by an unusual observation in a single patient.