高度肥満妊婦に対してX線透視下硬膜外カテーテル留置後に帝王切開を行った1症例

Cesarean Section with X-Ray Fluoroscopy-Guided Epidural Catheter Insertion in a Morbidly Obese Parturient Patient

要旨

　高度肥満妊婦の帝王切開の麻酔管理を経験した。肥満により区域麻酔困難が予測されたが，X線透視下硬膜外穿刺を選択し，安全に麻酔管理を行うことができた。高度肥満妊婦に対する帝王切開の麻酔法として，X線透視下硬膜外カテーテル留置による硬膜外麻酔が1つの選択肢となる可能性がある。

　A 32-year-old morbidly obese parturient patient was scheduled for an elective cesarean section. We considered neuraxial anesthesia to be challenging due to the patient’s obesity, and we thus performed the cesarean section under X-ray fluoroscopy-guided epidural catheter insertion. Epidural analgesia was initiated with 10mL of 2％ lidocaine and 10 mL of 0.375％ ropivacaine, resulting in S-T4 bilateral dermatomal sensory levels. The delivery was completed safely. This case demonstrates that X-ray fluoroscopy-guided epidural catheter insertion can be useful for administering epidural anesthesia in a morbidly obese parturient patient undergoing a cesarean section.