PDF(Pubmed)
Abstract：
Anesthesia management of fetal pulmonary valvuloplasty (FPV) is difficult, requiring careful consideration of both the mother and the fetus. Few reports have been published on specific anesthesia implementation and intraoperative management. We report the case of a pregnant woman who was treated with FPV under combined spinal epidural anesthesia (CSEA) with dexmedetomidine in the second trimester of pregnancy. Meanwhile, the application of fetal anesthesia through the umbilical vein was optimal. During the operation, the vital signs of the pregnant woman were stable with no complications and the fetal bradycardia was corrected by intracardiac injection of epinephrine. Four months postoperatively, a boy was born alive by full-term transvaginal delivery. CSEA may be a suitable anesthesia method for FPV surgery. Nevertheless, maternal hemodynamic stability maintenance, effective fetal anesthesia, and timely fetal resuscitation were necessary.
摘要：
胎儿肺动脉瓣成形术（FPV）的麻醉管理很困难，需要仔细考虑母亲和胎儿。关于具体麻醉实施和术中管理的报道很少。我们报告了一例孕妇，该孕妇在妊娠中期接受右美托咪定的腰硬联合麻醉（CSEA）下接受FPV治疗。同时,胎儿经脐静脉麻醉的应用效果最佳。在操作过程中,孕妇的生命体征稳定，无并发症，心内注射肾上腺素纠正了胎儿心动过缓。术后四个月,一个男孩通过足月经阴道分娩活着出生。CSEA可能是FPV手术的合适麻醉方法。然而，维持母体血流动力学稳定,有效的胎儿麻醉，及时的胎儿复苏是必要的。
