Korean J Anesthesiol.  1999 Apr;36(4):740-746. 10.4097/kjae.1999.36.4.740.

General Anesthesia for Cesarean Section in a Pregnant Woman with Eisenmenger's Syndrome

• Park JW
• Moon HH
• Cheong SH
• Choe YK
• Kim YJ
• Shin CM
• Park JY

• KMID: 2091396
• DOI: http://doi.org/10.4097/kjae.1999.36.4.740

Abstract

Eisenmenger's syndrome is the presence of high pulmonary vascular resistance associated with pulmonary hypertension at or near systemic values, with a reversed or bidirectional shunt. When patients with this syndrome become pregnant, these anatomic and physiologic changes can become additionally altered. An understanding of these changes along with anesthesia and pharmacologic interventions is necessary for the successful management of delivery and puerperium in such a disease entity associated with high maternal and fetal mortality. We report the successful anesthetic management of a pregnant patient with Eisenmenger's syndrome, whose baby was delivered by elective cesarean section under general anesthesia. Anesthesia was induced with ketamine, and maintained with ketamine, midazolam, and fentanyl. The patient was ventilated with 100% O2. Invasive hemodynamic monitoring such as systemic and pulmonary artery pressure was continued throughout delivery and puerperium in pregnant patients with this syndrome. The mother and baby were discharged home 10 days later without complication.

Keyword

Anesthesia, general; Eisenmenger's syndrome; Surgery, cesarean section

MeSH Terms

Anesthesia
Anesthesia, General*
Cesarean Section*
Eisenmenger Complex*
Female
Fentanyl
Fetal Mortality
Hemodynamics
Humans
Hypertension, Pulmonary
Ketamine
Midazolam
Mothers
Postpartum Period
Pregnancy
Pregnant Women*
Pulmonary Artery
Vascular Resistance
Fentanyl
Ketamine
Midazolam