Caesarean section in Eisenmenger’s syndrome: anaesthetic management with titrated epidural and nebulised alprostadil
Keywords:
alprostadil, Caesarean section, Eisenmenger’s syndrome, epiduralAbstract
Pregnancy in patients with Eisenmenger’s syndrome is associated with a high mortality. This article reports two cases of women with Eisenmenger’s syndrome (secondary to two different primary cardiac defects) who presented with near-term pregnancies. Both the patients underwent successful elective Caesarean section with slowly titrated epidural anaesthesia. Nebulised prostaglandin E1(PGE1) analogue, alprostadil, administered immediately post-delivery resulted in a significant drop in systolic pulmonary artery pressures as measured from tricuspid regurgitant jet by transthoracic echocardiography. The postoperative period was uneventful in both patients. A slow induction of epidural anaesthesia can be a safe mode of anaesthesia for Caesarean section in pregnant patients with Eisenmenger’s syndrome. Nebulised alprostadil intraoperatively or postoperatively in the intensive care unit (ICU) is readily available and a relatively cheap option as a selective pulmonary vasodilator in developing countries. (Full text available online at www.medpharm.tandfonline.com/ojaa) Southern African Journal of Anaesthesia and Analgesia 2016; 22(2):65–67; DOI: 10.1080/22201181.2016.1145432Downloads
Published
2016-05-05
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Case Studies
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