Abstract
A pregnant patient at 38 weeks gestation presentedfor a combined procedure of Caesarean section, tubal ligation and cerebral aneurysm clipping. Anaesthesia was induced with thiopental, succinylchoime was administered to facilitate tracked intubation, and intravenous lidocaine and sodium nitroprusside were used to reduce the hypertensive response to tracheal intubation. Anaesthesia was maintained with nitrous oxide until delivery of the infant, after which time fentanyl, low-dose halothane and pancuronium were added for maintenance of anaesthesia during the neurosurgical procedure. Blood pressure was controlled during the case by administration of a sodium nitroprusside infusion and propranolol. Following completion of the surgical procedures, the patient promptly emerged from anaesthesia and was neurologically normal in the operating room. It is concluded that general anaesthesia can be used satisfactorily for a combined procedure of Caesarean section and cerebral aneurysm clipping.
Résumé
Une femme enceinte de 38 semaines devait subir une césarienne, une ligature tubaire et une cure d’ané-vrisme cérébral au cours de la même anesthésie. On induisit l’anesthésie avec du thiopental et de la succinyl-choline; de la lidocaine et du nitroprussiate de sodium ont ete utilisés pour réduire la réponse hypertensive à Iintubation. Jusqu’à la naissance de l’enfant on n’administra que du protoxyde d’azote. Après la naissance, l’anesthesie fut maintenue avec dufentanyl et des petites doses d’halothane et de pancuronium pour la durée de l’intervention neurochirurgicale. On contróla la pression artiriélle avec du propranolol et une infusion de nitroprussiate de sodium. Après l’intervention, la patienle se réveilla en salle d’opération en état neurologique normal: on conclut que l’anesthésie générale peut être utilisée de façon satisfaisante pour des interventions de ce type.
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Conklin, K.A., Herr, G. & Fung, D. Anaesthesia for Caesarean section and cerebral aneurysm clipping. Can Anaesth Soc J 31, 451–454 (1984). https://doi.org/10.1007/BF03015424
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DOI: https://doi.org/10.1007/BF03015424