[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.
Department of Anesthesia and Pain Medicine, Kagawa University Hospital, Kagawa 761-0793.
Yuki
Y
Miyawaki
Tomoko
T
Yumiba
Takehiko
T
Asaga
Satoshi
S
Taie
Gotaro
G
Shirakami
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