Anesth Pain Med.  2007 Oct;2(4):246-251.

Perioperative Management of a Parturient with Eisenmenger's Syndrome Undergoing Cesarean Section :A case report

• Lee SY
• Ko JS
• Jung JW
• Lee SM
• Kang IS
• Park SW
• Roh CR

Abstract

The Eisenmenger's syndrome is presented with an abnormal communication between the systemic and pulmonary circulations and a predominant right to left shunt caused by increased vascular resistance in the pulmonary circulation. The maternal mortality and morbidity rate associated with cesarean section in the presence of Eisenmenger's syndrome is very high. We report a successful anesthetic management of a patient with the Eisenmenger's syndrome who underwent emergency cesarean section under general anesthesia, which is the first case in Korea of using nitric oxide in an attempt to improve pulmonary hypertension and arterial oxygenation. In addition to the basic monitoring devices, arterial and pulmonary catheters were inserted before the anesthesia. A fall in blood pressure was immediately counteracted by the administration of norepinephrine, and loss of blood by transfusion and fluid. After the operation, patient was closely monitored at coronary care unit for 15 days and discharged 18 days after the delivery without complication.

Keyword

anesthesia; cesarean section; eisenmenger complex; general; nitric oxide

MeSH Terms

Anesthesia
Anesthesia, General
Blood Pressure
Catheters
Cesarean Section*
Coronary Care Units
Eisenmenger Complex*
Emergencies
Female
Humans
Hypertension, Pulmonary
Korea
Maternal Mortality
Nitric Oxide
Norepinephrine
Oxygen
Pregnancy
Pulmonary Circulation
Vascular Resistance
Nitric Oxide
Norepinephrine
Oxygen