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妊娠前症候群の重症患者におけるカテゴリー1の緊急帝王切開のためのプロポポールの標的制御注入による全静脈麻酔

Janos Szederjesi¹, Emoke Almasy¹, Oana Elena Branea¹

¹Department of Anesthesiology and Intensive Care, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540139 Târgu Mureș, Romania.

Life (Basel, Switzerland)

|August 28, 2025

まとめ

プロポフールを用いた標的制御注射による全静脈麻酔 (TIVA- TCI) は,重度の妊娠前出産における安定した麻酔の選択肢です. この方法は,血液動力学的安定性と制御された麻酔の深さを,特に神経軸技術が禁忌である場合に提供します.

科学分野:

麻酔科
産婦人科
薬理学について

背景:

重度の妊娠前出血症は緊急帝王切開での麻酔に重大な問題をもたらします
神経学的症状のために神経軸麻酔は禁忌であり,代替的な全身麻酔技術が必要である.
伝統的な全身麻酔は高血圧を悪化させ母親と胎児のリスクを高めます

研究の目的:

TIVA- TCIとプロポポールの安全性と有効性を評価するために,重症性出産前症候群の患者のカテゴリ1の帝王切開.
血液動力学的安定性,薬剤の必要性,母親と新生児のアウトカムを評価する.
TIVA-TCIとプロポフォルを,この高リスク産婦人科における伝統的な全身麻酔と比較する.

主な方法:

重度の妊娠前出血症の2人の患者は,プロポフール (Marshモデル) を使用したTIVA- TCIによるカテゴリー1の帝王切開を受けた.
血液動力学的パラメータ,酸素量,薬剤投与,母親と新生児のアウトカムを注意深くモニターした.
痛みを和らげるためのスフェンタニル,神経筋阻害のためのロキュロニウム,逆転のためのスガマデックスを使用した. BISとTOFのモニタリングは利用できませんでした.

主要な成果:

両方の患者は手術過程で安定した血動力学と十分な酸素供給を示した.
効果部位濃度3. 5μg/ mlで成功した.
新生児のApgarスコアは正常な範囲内であり,母親や新生児に重大な手術内および手術後の合併症はなかった.

結論:

TIVA- TCIとプロポフォルは,特に神経麻酔が実現できない場合,重度の妊娠前症候群の患者のカテゴリー1の帝王切開のための揮発性麻酔剤の有効な代替品です.
この技術は血液動力学的安定性を確保し,麻酔の深さの正確な制御を可能にします.
TIVA-TCIは効果的ですが,経験豊富なスタッフを必要とし,非常に迅速な誘導を必要とするケースには理想的ではありません.

キーワード:

マッシュ・モデル TIVA-TCI について c 切断妊娠前出血症プロポポール

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