脊髓-硬膜外联合麻醉对马凡氏综合征分娩的管理:1例报告

IF 0.2 Q4 ANESTHESIOLOGY
M. Malinovic, Kimberly Babiash, F. Newton
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引用次数: 0

摘要

马凡氏综合征患者妊娠与风险相关,包括心血管并发症。妊娠期血流动力学改变对马凡氏综合征患者是有害的。本病例描述了一例马凡氏综合征孕妇主动脉根部扩张bbbb45毫米,经轴向麻醉和剖宫产。麻醉管理的重点是降低高血压和对升主动脉的剪切力。剖宫产采用脊髓-硬膜外联合低剂量高压布比卡因。多学科方法在马凡氏综合征妊娠和心血管并发症的管理中至关重要,在计划分娩和产后管理时必须考虑。麻醉管理必须考虑妊娠期血流动力学变化、马凡氏综合征累及孕妇心血管的严重程度以及新生儿风险。关于分娩时间和产后主动脉修复的麻醉管理指南的制定将有利于马凡氏综合征产妇。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Combined spinal-epidural anesthetic management of delivery for marfan syndrome: Case report
Pregnancy in a patient with Marfan syndrome is associated with risks, including cardiovascular complications. The hemodynamic changes of pregnancy during delivery are deleterious to Marfan syndrome patients. This case describes a Marfan syndrome parturient with dilated aortic root >45 mm who underwent neuraxial anesthesia and cesarean delivery. Anesthetic management focused on reducing hypertension and shear forces on the ascending aorta. A combined spinal-epidural with a reduced dose of hyperbaric bupivacaine was utilized for cesarean delivery. Multidisciplinary approaches are vital in the management of Marfan syndrome pregnancy and cardiovascular complications must be considered when planning for delivery and postpartum management. Anesthetic management must consider the hemodynamic changes in pregnancy and severity of Marfan syndrome cardiovascular involvement in the parturient as well as neonatal risks. Guideline development concerning anesthetic management for both the timing of delivery and aortic repair postpartum would be beneficial to Marfan syndrome parturients.
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29 weeks
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