Korean J Anesthesiol.  2000 Mar;38(3):563-566. 10.4097/kjae.2000.38.3.563.

Epidural Anesthesia for Cesarean Section in a Parturient with Eisenmenger's Syndrome

• Hwang BM
• Sim JY
• Cho SK
• Lee DM

• KMID: 2237298
• DOI: http://doi.org/10.4097/kjae.2000.38.3.563

Abstract

Eisenmenger's syndrome is defined as pulmonary hypertension with right-to-left or bidirectional shunting of blood through an intracardiac or aorto-pulmonary commumication. It can occur with complex congenital cardiac malformations, such as septal defect and patent ductus arteriosus. Parturients with Eisenmenger's syndrome are at high risk for peripartum morbidity and mortality. We experienced a case of parturient for cesarean section with Eisenmenger's syndrome and performed epidural anesthesia with fractionated doses of 2% lidocaine and fentanyl. The sensory block reached to T10 level and blood pressure was maintained with intravenous phenylephrine. After baby out, sudden hypotension with severe bradycardia developed and arterial oxygen saturation dropped. Immediate intubation and resuscitation was done, but cardiac rhythm disturbance, hypoxemia, and acidosis did not corrected. Cardiac standstill developed and stopped resuscitation. The neonate's Apgar score was 7 and he was transferred to pediatric ICU.

Keyword

Anesthesia: obstetric; Anesthetics, local: lidocaine; Anesthetic techniques: epidural; Heart: Eisenmenger's syndrome; Surgery: cesarean section

MeSH Terms

Acidosis
Anesthesia, Epidural*
Anoxia
Apgar Score
Blood Pressure
Bradycardia
Cesarean Section*
Ductus Arteriosus, Patent
Eisenmenger Complex*
Female
Fentanyl
Hypertension, Pulmonary
Hypotension
Intubation
Lidocaine
Mortality
Oxygen
Peripartum Period
Phenylephrine
Pregnancy
Resuscitation
Fentanyl
Lidocaine
Oxygen
Phenylephrine