BACKGROUND Primary hyperparathyroidism(PHPT)is the most common cause of pregnancyrelated hypercalcemia.PHPT can cause maternal and fetal complications in pregnant women.General anesthesia for non-obstetric surgery in ...BACKGROUND Primary hyperparathyroidism(PHPT)is the most common cause of pregnancyrelated hypercalcemia.PHPT can cause maternal and fetal complications in pregnant women.General anesthesia for non-obstetric surgery in pregnant women is associated with maternal hazards and concerns regarding long-term neonatal neurocognitive effects.Surgical removal of the lesion in mid-pregnancy is currently the primary treatment option for pregnant patients with PHPT.However,the blood calcium concentration at which surgery should be considered remains under discussion due to the risk of miscarriage.CASE SUMMARY A 31-year-old nulliparous woman at 11 wk of gestation was admitted to our hospital for parathyroidectomy.The patient had a history of intrauterine fetal death with unknown etiology at 16 wk of gestation 1 year prior.Her blood test results showed that the serum calcium level was elevated to 12.9 mg/dL,and the parathyroid hormone level was elevated to 157 pg/mL.In a neck ultrasound,it revealed a 0.8 cm×1.5 cm sized oval,hypoechoic mass in the upper posterior of the left thyroid gland,which was compatible with parathyroid adenoma.Superficial cervical plexus block(SCPB)for parathyroidectomy was performed.After surgery,the obstetrician checked the status of the fetus,and there were no abnormal signs.Since then her calcium level returned to normal values after one week of surgery and a healthy male neonate of 2910 g was delivered vaginally at 38 wk of gestation.CONCLUSION Our case suggests that SCPB can be an anesthetic option for parathyroidectomy during the first trimester of pregnancy.展开更多
目的:观察地佐辛静脉注射与左旋布比卡因+利多卡因行浅颈丛注射两种方法用于甲状腺术后镇痛效果的比较。方法:全麻下行甲状腺切除术患者60例,随机分为3组:对照组(C组)在全麻诱导即刻给予静脉注射生理盐水5 m L;地佐辛组(D组)在全麻诱导...目的:观察地佐辛静脉注射与左旋布比卡因+利多卡因行浅颈丛注射两种方法用于甲状腺术后镇痛效果的比较。方法:全麻下行甲状腺切除术患者60例,随机分为3组:对照组(C组)在全麻诱导即刻给予静脉注射生理盐水5 m L;地佐辛组(D组)在全麻诱导后即刻静脉注射地佐辛10 mg;颈丛阻滞组(B组)在全麻诱导前行双侧颈浅丛阻滞,每侧各6 m L(局麻药为0.375%左旋布比卡因+1%利多卡因合剂)。分别观察3组患者术后4、8、12、24 h的切口疼痛、咽痛以及恶心呕吐发生率。结果:B组和D组的患者VAS评分比较差异无统计学意义,在术后12 h以内各时点的镇痛评分均小于C组,差异有统计学意义。3组患者用药后的不良反应差异无统计学意义。结论:术前静脉注射地佐辛注射液或者行颈浅丛神经阻滞注射利多卡因与左旋布比卡因混合液均可为甲状腺切除手术术后12 h内提供良好的术后镇痛,且不增加不良反应的发生率。展开更多
文摘BACKGROUND Primary hyperparathyroidism(PHPT)is the most common cause of pregnancyrelated hypercalcemia.PHPT can cause maternal and fetal complications in pregnant women.General anesthesia for non-obstetric surgery in pregnant women is associated with maternal hazards and concerns regarding long-term neonatal neurocognitive effects.Surgical removal of the lesion in mid-pregnancy is currently the primary treatment option for pregnant patients with PHPT.However,the blood calcium concentration at which surgery should be considered remains under discussion due to the risk of miscarriage.CASE SUMMARY A 31-year-old nulliparous woman at 11 wk of gestation was admitted to our hospital for parathyroidectomy.The patient had a history of intrauterine fetal death with unknown etiology at 16 wk of gestation 1 year prior.Her blood test results showed that the serum calcium level was elevated to 12.9 mg/dL,and the parathyroid hormone level was elevated to 157 pg/mL.In a neck ultrasound,it revealed a 0.8 cm×1.5 cm sized oval,hypoechoic mass in the upper posterior of the left thyroid gland,which was compatible with parathyroid adenoma.Superficial cervical plexus block(SCPB)for parathyroidectomy was performed.After surgery,the obstetrician checked the status of the fetus,and there were no abnormal signs.Since then her calcium level returned to normal values after one week of surgery and a healthy male neonate of 2910 g was delivered vaginally at 38 wk of gestation.CONCLUSION Our case suggests that SCPB can be an anesthetic option for parathyroidectomy during the first trimester of pregnancy.
文摘目的:观察地佐辛静脉注射与左旋布比卡因+利多卡因行浅颈丛注射两种方法用于甲状腺术后镇痛效果的比较。方法:全麻下行甲状腺切除术患者60例,随机分为3组:对照组(C组)在全麻诱导即刻给予静脉注射生理盐水5 m L;地佐辛组(D组)在全麻诱导后即刻静脉注射地佐辛10 mg;颈丛阻滞组(B组)在全麻诱导前行双侧颈浅丛阻滞,每侧各6 m L(局麻药为0.375%左旋布比卡因+1%利多卡因合剂)。分别观察3组患者术后4、8、12、24 h的切口疼痛、咽痛以及恶心呕吐发生率。结果:B组和D组的患者VAS评分比较差异无统计学意义,在术后12 h以内各时点的镇痛评分均小于C组,差异有统计学意义。3组患者用药后的不良反应差异无统计学意义。结论:术前静脉注射地佐辛注射液或者行颈浅丛神经阻滞注射利多卡因与左旋布比卡因混合液均可为甲状腺切除手术术后12 h内提供良好的术后镇痛,且不增加不良反应的发生率。
