Oxygen Delivery in Cesarean Section for a Jehovah's Witness Complicated with Uterine Myoma

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  • HARA Tetsuya
    Department of Anesthesiology, Nagasaki University Hospital of Medicine and Dentistry
  • INADOMI Chiaki
    Department of Anesthesiology, Nagasaki University School of Medicine
  • KOIDE Fumiko
    Department of Anesthesiology, Nagasaki University Hospital of Medicine and Dentistry
  • MAEKAWA Takuji
    Department of Anesthesiology, Nagasaki University Hospital of Medicine and Dentistry
  • CHO Sungsam
    Department of Anesthesiology, Nagasaki University Hospital of Medicine and Dentistry
  • SUMIKAWA Koji
    Department of Anesthesiology, Nagasaki University School of Medicine

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  • エホバの証人の帝王切開術における酸素供給量の変化

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Abstract

  Oxygen delivery is dependent on hemoglobin concentration, SaO2, PaO2 and cardiac output. Decrease of hemoglobin concentration during massive hemorrhage results in decrease of systemic oxygen delivery. We report a case of a 40-year-old female Jehovah's Witness complicated with uterine myoma scheduled for Cesarean section under spinal anesthesia. Oxygen delivery was calculated with cardiac output measured by the arterial pressure waveform analysis method. Inotropic agents and fluids were administered to augment cardiac output to maintain oxygen delivery within the normal range against decrease of hemoglobin concentration. Monitoring of oxygen delivery with continuous cardiac output measurement by the arterial pressure waveform analysis method is minimally invasive and would be efficacious in anesthetic management of bloodless surgery for patients refusing transfusion therapy.

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