Korean J Anesthesiol.  2013 Aug;65(2):158-162. 10.4097/kjae.2013.65.2.158.

Application of cerebral oximetry for a parturient with Takayasu's arteritis undergoing cesarean section: a case report

• Lee EH
• Choi E
• Ahn W

• KMID: 2031259
• DOI: http://doi.org/10.4097/kjae.2013.65.2.158

Abstract

Takayasu's arteritis (TA) is a chronic inflammatory disease involving the aorta. Because TA sometimes involves cerebral arteries, anesthetic debates focus on cerebral monitoring. There is limited evidence as to which cerebral monitoring method is most adequate. Furthermore, there is insufficient evidence to determine which anesthetic technique is better for TA parturients. We experienced the case of a TA parturient who developed transient cerebral ischemia during cesarean section. The patient's TA involved her cerebral arteries, and her regional cerebral oxygen saturation (rSO2) was lower in the left side than in the right side. She complained of speech impairment, tinnitus, and stiffness of the posterior neck when the rSO2 levels dropped. The FloTrac/Vigileo(TM) system did not correlate with clinical symptoms, but the cerebral oximeter displayed the low oxygen saturation. We recommend the cerebral oximetry for cerebral monitoring in TA parturients who undergo cesarean sections, especially in hemodynamically unstable patients under regional anesthesia or unconscious patients under general anesthesia.

Keyword

Cerebral oximetry; Cesarean section; Epidural anesthesia; Near-infrared spectroscopy; Takayasu's arteritis

MeSH Terms

Anesthesia, Conduction
Anesthesia, Epidural
Anesthesia, General
Aorta
Cerebral Arteries
Cesarean Section
Female
Humans
Ischemic Attack, Transient
Neck
Oximetry
Oxygen
Pregnancy
Spectroscopy, Near-Infrared
Takayasu Arteritis
Tinnitus
Unconscious (Psychology)
Oxygen