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Canadian Journal of Anesthesia, Vol 38, 895-899, Copyright © 1991 by Canadian Anesthesiologists' Society

ARTICLES

Pulmonary hypertension and cardiomyopathy: anaesthetic management for caesarean section

TW Breen and JA Janzen
Department of Anaesthesia, Foothills Hospital, University of Calgary, Alberta.

Pulmonary hypertension in pregnant women is uncommon but is associated with a high mortality. We present the case of a 14-yr-old parturient with pulmonary hypertension and cardiomyopathy who required a Caesarean section. Management goals included: (1) maintaining right ventricular function, (2) avoiding the haemodynamic effects of general endotracheal anaesthesia, and (3) minimizing narcotic-related neonatal respiratory depression. While most authors agree on invasive pulmonary and systemic monitoring, opinions differ as to the optimal method of providing anaesthesia for these patients. The successful use of lumbar epidural anaesthesia with lidocaine and fentanyl is described. When the local anaesthetic was administered slowly and in increments, epidural anaesthesia was safe for both mother and fetus.


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R. Shnaider, T. Ezri, P. Szmuk, S. Larson, R. D. Warters, and J. Katz
Combined spinal-epidural anesthesia for Cesarean section in a patient with peripartum dilated cardiomyopathy : [L'anesthesie rachidienne et peridurale combinee pour la cesarienne chez une patiente souffrant de cardiomyopathie du peripartum]
Can J Anesth, July 1, 2001; 48(7): 681 - 683.
[Abstract] [Full Text] [PDF]


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Copyright © 1991 by the Canadian Anesthesiologists' Society.