[Remifentanil is useful for cardiovascular stability during cesarean delivery in a parturient with Marfan's syndrome].

Abstract

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.

• Authors: Yuki Miyawaki, Tomoko Yumiba, Takehiko Asaga, Satoshi Taie, Gotaro Shirakami
• Journal: Masui. The Japanese journal of anesthesiology (Masui) Vol. 59 Issue 10 Pg. 1305-7 (Oct 2010) ISSN: 0021-4892 [Print] Japan
• PMID: 20960910 (Publication Type: Case Reports, Journal Article)

Chemical References

• Analgesics, Opioid
• Piperidines
• Remifentanil

Topics

• Adult
• Analgesics, Opioid (pharmacology)
• Anesthesia, General (methods)
• Anesthesia, Obstetrical (methods)
• Cesarean Section
• Female
• Hemodynamics (drug effects)
• Humans
• Marfan Syndrome (complications)
• Piperidines (pharmacology)
• Pregnancy
• Remifentanil