Two Cases of Cesarean Sections Performed with Combined Spinal-Epidural Anesthesia with Perioperative Asthma Attacks
- VernacularTitle:周術期喘息発作に対して半夏厚朴湯が著効し，安全に硬膜外併用脊髄くも膜下麻酔で行った帝王切開の2例
- Author:
Isao FUKUDA
1
;
Hideyuki NAKATA
2
;
Munetaka KUSAKADO
3
;
Takaaki KOSUGE
3
Author Information
- Keywords: hangekobokuto; asthma attack; dyspnea; baikakuki (foreign body sensation in the throat); cesarean section
- From:Kampo Medicine 2023;74(1):20-24
- CountryJapan
- Language:Japanese
- Abstract: Asthma attack difficulty breathing rapidly worsens the condition over time. Especially when the condition worsens before surgery, general anesthesia (GA) may be indicated depending on the type of surgery. In Japan, there is a tendency to avoid GA in cesarean section (C/S) due to the risk of difficult intubation, adverse effects on the fetus, and concerns about resuscitation of the newborn. This time, foreign body sensation in the throat (baikakuki) was found in a case of asthma-like attack accompanied by difficulty breathing caused by disturbance symptoms on the day of C/S and in a case of difficulty breathing due to preoperative antibiotic intravenous drip. After oral administration of hangekobokuto to the patients, dyspnea disappeared in either case, and I was able to avoid GA and perform C/S with combined spinal-epidural anesthesia. Considering asthma in Kampo medicine, it is thought that psychoactive predispositions such as anxiety and impatience are the triggers that cause qi counter flow and qi stagnation, which causes phlegm to condense, resulting in baikakuki and symptoms. Therefore, it was thought that hangekobokuto, which remove phlegm, was adapted.
