Anesthésie pour césarienne chez une patiente présentant une dissection aortique compliquée
Autor: | A. Slama, K. Ben Jazia, H. Jegham, D. Ben Letaifa, M Methamem |
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Rok vydání: | 2002 |
Předmět: |
Bupivacaine
Aortic dissection Marfan syndrome medicine.medical_specialty business.industry medicine.medical_treatment General Medicine Dissection (medical) medicine.disease Preoperative care Surgery Anesthesiology and Pain Medicine medicine.anatomical_structure Anesthesia Mitral valve cardiovascular system medicine Caesarean section business Combined spinal and epidural anaesthesia medicine.drug |
Zdroj: | Annales Françaises d'Anesthésie et de Réanimation. 21:672-675 |
ISSN: | 0750-7658 |
Popis: | We report the anaesthetic management of a 32-year-old pregnant women with aortic dissection and Marfan syndrome for caesarean section. The patient has presented at 31 weeks gestation of a first pregnancy an aortic dissection that required an emergency aortic replacement. Three years later, she presented at 31 weeks gestation with aortic dissection, mitral valve dysfunction and acute pulmonary oedema. She was treated in intensive care unit with deslanoside, diuretic and twice a day echographic examination. Delivery was planned by caesarean section after haemodynamic stabilisation on the sixth day. Combined spinal and epidural anaesthesia was performed after monitoring. The initial intrathecal injection of bupivacaine, morphine and fentanyl provided rapid onset of analgesia. Epidural anaesthesia was used with diluted lidocaine and fentanyl boluses. With appropriate preoperative care and monitoring, uneventful combined spinal and epidural anaesthesia for Caesarean section was achieved in a patient with Marfan syndrome in the presence of aortic dissection complicated by mitral valve dysfunction and acute pulmonary oedema. |
Databáze: | OpenAIRE |
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