Korean J Anesthesiol.  2007 May;52(5):605-608. 10.4097/kjae.2007.52.5.605.

Combined Spinal-epidural Anesthesia for Cesarean Section in a Patient with Peripartum Cardiomyopathy: A case report

• Park HY
• Goo EK
• Do SH
• Park KS

• KMID: 2239884
• DOI: http://doi.org/10.4097/kjae.2007.52.5.605

Abstract

Peripartum cardiomyopathy (PPCM) is a rare form of cardiomyopathy associated with a significant morbidity and mortality. The anesthetic management of a Cesarean section in patients with PPCM has not been well defined. Herein, our experience of a 31-year-old multipara, with recurrent PPCM and congestive heart failure, who presented for an elective cesarean section, is reported. Combined spinal-epidural anesthesia was successfully employed as the anesthetic technique for the procedure. The intra-arterial blood pressure and central venous pressure were monitored throughout the procedure. In addition, the patient's postoperative pain was markedly reduced with the use of epidural PCA. Combined spinal-epidural anesthesia is suggested to be a reliable technique, which provides minimal hemodynamic changes, and a lower failure rate than epidural anesthesia only, and is also highly effective with a low dose of local anesthetic drug.

Keyword

cesarean section; combined spinal-epidural anesthesia; peripartum cardiomyopathy

MeSH Terms

Adult
Anesthesia*
Anesthesia, Epidural
Blood Pressure
Cardiomyopathies*
Central Venous Pressure
Cesarean Section*
Female
Heart Failure
Hemodynamics
Humans
Mortality
Pain, Postoperative
Passive Cutaneous Anaphylaxis
Peripartum Period*
Pregnancy