[Remifentanil is useful for cardiovascular stability during cesarean delivery in a parturient with Marfan's syndrome].
A 25-year-old parturient with Marfan's syndrome was scheduled for cesarean delivery. She suffered with severe scoliosis and asymptomatic aortic root dilatation. To establish a cardiovascular stability and prevent aortic dissection perioperatively, we selected the use of remifentanil, an ultra-short acting opioid analgesic with general anesthesia. General anesthesia was induced with remifentanil (0.2 microg x kg(-1) x min(-1)), propofol (100 mg), and vecuronium bromide (10 mg). Anesthesia was maintained with 100% O2, sevoflurane (1-1.5%), and remifentanil (0.2-0.25 microg x kg(-1) x min(-1)). She remained hemodynamically stable during surgery. A lively infant was delivered and Apgar scores were 8 and 9 at 1 and 5 min, respectively. Their post-delivery courses were uneventful. Remifentanil was useful for anesthetic management in a pregnant patient with Marfan's syndrome undergoing cesarean delivery, although attention to infant's respiratory condition should be paid because remifentanil can cross the placenta.
Miyawaki
Yuki
Y
Department of Anesthesia and Pain Medicine, Kagawa University Hospital, Kagawa 761-0793.
Yumiba
Tomoko
T
Asaga
Takehiko
T
Taie
Satoshi
S
Shirakami
Gotaro
G
D000328:Adult; D000701:Analgesics, Opioid / Q000494:pharmacology*; D000768:Anesthesia, General / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000379:methods*; D002585:Cesarean Section; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008382:Marfan Syndrome / Q000150:complications*; D010880:Piperidines / Q000494:pharmacology*; D011247:Pregnancy; D000077208:Remifentanil
D000701:Analgesics, Opioid; D010880:Piperidines; D000077208:Remifentanil