Eisenmenger씨 증후군 산모에서의 제왕절개술을 위한 전신 마취 경험 - 증례 보고

Eisenmenger's syndrome is the presence of high pulmonary vascular resistance associated with pulmonary hypertension at or near systemic values, with a reversed or bidirectional shunt. When patients with this syndrome become pregnant, these anatomic and physiologic changes can become additionally altered. An understanding of these changes along with anesthesia and pharmacologic interventions is necessary for the successful management of delivery and puerperium in such a disease entity associated with high maternal and fetal mortality. We report the successful anesthetic management of a pregnant patient with Eisenmenger's syndrome, whose baby was delivered by elective cesarean section under general anesthesia. Anesthesia was induced with ketamine, and maintained with ketamine, midazolam, and fentanyl. The patient was ventilated with 100% O2. Invasive hemodynamic monitoring such as systemic and pulmonary artery pressure was continued throughout delivery and puerperium in pregnant patients with this syndrome. The mother and baby were discharged home 10 days later without complication. (Korean J Anesthesiol 1999; 36: 740∼746)