両側大動脈‐肺動脈バイパス術（グレン手術）後患者の帝王切開術の麻酔経験
書誌事項
- タイトル別名
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- Anesthetic management of cesarean section in a patient with single atrium and single ventricle after cavo-pulmonary bypass surgery.
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説明
A 30-year-old femele experienced a successful pregnacy without major complications. In her history, cavo-pulmonary shunt operation and replacement of common AV value was performed in a diagnosis of single ventricle and single atrium seven years ago. It was the first successful case of these operations in the world. She was admitted for disability (NYHA II) at the 27th week of pregnacy, and ceasrean section was scheduled due to heart failure (NYHA III) at the 36th week. General anesthesia was induced with fentanyl and ketamine and maintained with nitrous oxide, oxygen, fentanyl and diazepam. Since she possess no right atrium and ventricle, and pulmoary blood flow was dependent on the pressure difference between central vein and left atrium, we paid several attensions to maintain pulmonary blood flow. The points of this anesthetic management were considered as follows;<br>1) to keep appropriate central venous pressure (20-25torr)2) careful use of anesthetics, muscle relaxants and uterine stimulating drugs, especially which affect hemodynamics, 3) cardiac oscillation ventilation not to increase intrathoracic pressure, 4) to avoid over-infusion or-transfusion, 5) to avoid sudden circullatory collapse (spinal anesthesia may be contraindicated), 6) aorto-caval decompression, 7) to manage sleeping baby, etc. According to these managements, benign course of delivery was obtained.
収録刊行物
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- 日本臨床麻酔学会誌
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日本臨床麻酔学会誌 6 (3), 270-274, 1986
日本臨床麻酔学会
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詳細情報 詳細情報について
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- CRID
- 1390282679735572480
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- NII論文ID
- 130003582149
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- ISSN
- 13499149
- 02854945
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- 本文言語コード
- ja
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- データソース種別
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- JaLC
- Crossref
- CiNii Articles
- OpenAIRE
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- 抄録ライセンスフラグ
- 使用不可
