抄録
We describe the use of continuous spinal anesthesia (CSA) for an elective cesarean section in a 29-year-old parturient with Eisenmenger's syndrome at 30 weeks of gestation. It is essential in patients with Eisenmenger's syndrome to prevent significant increases in right-to-left shunt following the reduction in systemic vascular resistance. In this case, the patient hoped to be awake during the operation because of her fear of death. We therefore applied CSA to this patient because single-shot spinal anesthesia and epidural anesthesia might cause sudden cardiovascular depression. In fact, sudden cardiovascular changes were avoided by the titration of local anesthetics and the operation was uneventful, although prompt treatment of hypotension was essential and adjustment of the anesthetic levels was difficult. Postoperative patient-controlled spinal analgesia provided satisfactory pain relief with hemodynamic stability and no significant side effects. However, thorough experience with the requisite techniques is critical in CSA because of the technical difficulty of the procedure, and anesthesiologists must gain such experience in less-demanding cases before attempting to administer it in patients presenting extreme challenges as described in this case report.
| 元の言語 | English |
|---|---|
| ページ（範囲） | 300-303 |
| ページ数 | 4 |
| ジャーナル | Journal of Anesthesia |
| 巻 | 18 |
| 発行部数 | 4 |
| DOI | |
| 出版物ステータス | Published - 2004 11 |
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ASJC Scopus subject areas
- Anesthesiology and Pain Medicine
これを引用
Continuous spinal anesthesia and postoperative analgesia for elective cesarean section in a parturient with Eisenmenger's syndrome. / Sakuraba, Shigeki; Kiyama, Shuya; Ochiai, Ryoichi; Yamamoto, Shinichi; Yamada, Tatsuya; Hashiguchi, Saori; Takeda, Junzo.
：: Journal of Anesthesia, 巻 18, 番号 4, 11.2004, p. 300-303.研究成果: Article
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TY - JOUR
T1 - Continuous spinal anesthesia and postoperative analgesia for elective cesarean section in a parturient with Eisenmenger's syndrome
AU - Sakuraba, Shigeki
AU - Kiyama, Shuya
AU - Ochiai, Ryoichi
AU - Yamamoto, Shinichi
AU - Yamada, Tatsuya
AU - Hashiguchi, Saori
AU - Takeda, Junzo
PY - 2004/11
Y1 - 2004/11
N2 - We describe the use of continuous spinal anesthesia (CSA) for an elective cesarean section in a 29-year-old parturient with Eisenmenger's syndrome at 30 weeks of gestation. It is essential in patients with Eisenmenger's syndrome to prevent significant increases in right-to-left shunt following the reduction in systemic vascular resistance. In this case, the patient hoped to be awake during the operation because of her fear of death. We therefore applied CSA to this patient because single-shot spinal anesthesia and epidural anesthesia might cause sudden cardiovascular depression. In fact, sudden cardiovascular changes were avoided by the titration of local anesthetics and the operation was uneventful, although prompt treatment of hypotension was essential and adjustment of the anesthetic levels was difficult. Postoperative patient-controlled spinal analgesia provided satisfactory pain relief with hemodynamic stability and no significant side effects. However, thorough experience with the requisite techniques is critical in CSA because of the technical difficulty of the procedure, and anesthesiologists must gain such experience in less-demanding cases before attempting to administer it in patients presenting extreme challenges as described in this case report.
AB - We describe the use of continuous spinal anesthesia (CSA) for an elective cesarean section in a 29-year-old parturient with Eisenmenger's syndrome at 30 weeks of gestation. It is essential in patients with Eisenmenger's syndrome to prevent significant increases in right-to-left shunt following the reduction in systemic vascular resistance. In this case, the patient hoped to be awake during the operation because of her fear of death. We therefore applied CSA to this patient because single-shot spinal anesthesia and epidural anesthesia might cause sudden cardiovascular depression. In fact, sudden cardiovascular changes were avoided by the titration of local anesthetics and the operation was uneventful, although prompt treatment of hypotension was essential and adjustment of the anesthetic levels was difficult. Postoperative patient-controlled spinal analgesia provided satisfactory pain relief with hemodynamic stability and no significant side effects. However, thorough experience with the requisite techniques is critical in CSA because of the technical difficulty of the procedure, and anesthesiologists must gain such experience in less-demanding cases before attempting to administer it in patients presenting extreme challenges as described in this case report.
KW - Cesarean section
KW - Continuous spinal anesthesia
KW - Eisenmenger's syndrome
KW - Obstetric
KW - Subarachnoid
UR - http://www.scopus.com/inward/record.url?scp=8444235364&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=8444235364&partnerID=8YFLogxK
U2 - 10.1007/s00540-004-0256-2
DO - 10.1007/s00540-004-0256-2
M3 - Article
C2 - 15549474
AN - SCOPUS:8444235364
VL - 18
SP - 300
EP - 303
JO - Journal of Anesthesia
JF - Journal of Anesthesia
SN - 0913-8668
IS - 4
ER -