Epidural Anesthesia in Management of Pregnant Eissenmenger’s Syndrome Patient Undergoing Caesarean Section
DOI:
https://doi.org/10.37275/bsm.v8i2.932Keywords:
Anesthesia, Eissenmenger’s syndrome, EpiduralAbstract
Background: Eisenmenger syndrome is very rare in pregnant women. Debates remain concerning the management of Eisenmenger syndrome in this patient population, and the prognosis is unclear in terms of maternal and fetoneonatal outcomes. Managing anesthesia in maternal patients with a cardiac abnormality might be particularly difficult because these individuals have inadequate circulatory reserves and altered maternal cardiovascular physiology.
Case presentation: We present a 26-year-old 34 weeks pregnant woman with Eisenmenger’s syndrome (ES) scheduled for an elective caesarean section. The clinical findings reveal slight tachypnea with peripheral oxygen saturation of 82% with oxygen supplementation using a cannula at 3 lpm. The patient's baseline hemodynamics are stable, but a third-degree murmur is heard in the 3rd and 4th left intercostal space. The patient was managed with epidural anesthesia using bupivacaine 0.5% 20 ml without adjuvant. The epidural catheter was inserted in an interspinous process between L3-L4. The surgery was done in 90 minutes with stable hemodynamics, and postoperatively, the patient was monitored in the intensive cardiac care unit (ICCU).
Conclusion: Epidural anesthesia has been shown to provide favorable outcomes due to its slow onset and reducing the likelihood of abrupt hemodynamic changes.
Authors
- I Gusti Ngurah Bagus Jayantha Ananda1*
- Tjahya Aryasa2
- Tjokorda Gde Agung Senapathi 3
- 1Resident of Department of Anesthesiology, Pain Management, and Intensive Care, Universitas Udayana/Sanglah General Hospital, Denpasar, Indonesia
- 2Lecturer of Department of Anesthesiology, Pain Management, and Intensive Care, Universitas Udayana/Sanglah General Hospital, Denpasar, Indonesia
- 3Associated Professor of Department of Anesthesiology, Pain Management, and Intensive Care, Universitas Udayana/Sanglah General Hospital, Denpasar, Indonesia
Corresponding author I Gusti Ngurah Bagus Jayantha Ananda — jayanthaananda@student.unud.ac.id
Article history
- Submitted
- Accepted
- Published
Downloads
Published
Issue
Section
License
As our aim is to disseminate original research article, hence the publishing right is a necessary one. The publishing right is needed in order to reach the agreement between the author and publisher. As the journal is fully open access, the authors will sign an exclusive license agreement.
The authors have the right to:
- Share their article in the same ways permitted to third parties under the relevant user license.
- Retain copyright, patent, trademark and other intellectual property rights including research data.
- Proper attribution and credit for the published work.
For the open access article, the publisher is granted to the following right.
- The non-exclusive right to publish the article and grant right to others.
- For the published article, the publisher applied for the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
