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題名 | Awake Fiberoptic Intubation for Cesarean Section in a Parturient with Odontoid Fracture and Atlantoaxial Subluxation=產婦合併第一、第二頸椎骨折之剖腹產麻醉處理 |
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作者 | 黃樹欽; 黃潔文; 趙安祥; 梁景忠; 徐至清; Wong, Shu-yam; Wong, Kit-Man; Chao, An-Shine; Liang, Ching-chung; Hsu, Jee-ching; |
期刊 | 長庚醫學 |
出版日期 | 20030500 |
卷期 | 26:5 2003.05[民92.05] |
頁次 | 頁352-356 |
分類號 | 417.372 |
語文 | eng |
關鍵詞 | 第一、第二頸椎不全脫位; 清醒光纖管插管; Atlantoaxial subluxation; Awake fiberoptic intubation; |
中文摘要 | 此病例為懷孕38週之孕婦,因不尋常受傷而引致高位頸椎損傷之麻醉經驗。該名產婦因四肢癱瘓及感覺消失而經由他院轉入本院。頸部x-ray及CT顯示第一、二頸椎不全脫位及第二頸椎齒突骨折,由於劇烈宮縮而再轉入產房待產。我們計劃替她施行剖腹產,因為高位頸椎受傷不方便施以區域半身麻醉,故利用光纖維儀器經鼻清醒插管後,給予全身麻醉。整個剖腹產及麻醉過程相當平順,母子均安。我們報告相關的麻醉處理、插管技巧及文獻回顧。 |
英文摘要 | We report on the anesthetic experience of a 38-week pregnant patient in labor with an upper cervical spinal cord injury after an unusual trauma. She was transferred from a district hospital to our medical center with acute quadriplegia and sensory loss. Plain cervical spine x-ray and computed tomographic scan showed a C2 odontoid (dens of axis) process type II fracture and atlantoaxial (C1-C2) subluxation. Due to having regular uterine contractions and labor pain, she was scheduled for an urgent cesarean section. The instability of her cervical spine precluded the use of regional anesthesia; so awake nasal fiberoptic endotracheal intubation followed by general anesthesia was performed. The anesthetic course was uneventful, and the outcome of the parturient and newborn was good. We discuss our anesthetic considerations, intubation techniques and a review of the literature. |
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