제왕 절개술을 위한 전신마취 시 병적비만 산모에서 sugammadex의 사용

Abstract

Morbid obesity in a pregnancy is a great challenge to medical practice especially when the patient requires Caesarean section. A 38-year-old primigravida (127.5 kg, 164 cm, BMI 47.4 kg/m2) with fetal breech presentation was scheduled Caesarean section at 39-week gestation. After informed consent, anesthesia was induced in rapid sequence with propofol and rocuronium (1 mg/kg), which was monitored with train- offour stimulation and bispectral index scale. Intubation was performed using Pentax-AWS® video laryngoscope, and anesthesia was maintained with sevoflurane and remifentanil. When the operation was over, the patient was extubated at TOF ratio 0.98 after reversal with sugammadex (2 mg/kg). We report sugammadex is a quick, safe, and effective reversal of rocuroniuminduced neuromuscular block in morbidly obese paturient during Caesarean section under general anesthesia.