Vasopressin infusion during combine spinal epidural anesthesia for cesarean section in a patient with severe mitral stenosis with pulmonary hypertension
Presence of mitral stenosis deteriorates the already compromised cardiac status of a pregnant female. Decision between regional and general anesthesia can be crucial in such cases. Our patient a 20-year-old, and primigravida scheduled for emergency cesarean section due to acute fetal distress was a...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2016-01-01
|
| Series: | Egyptian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1110184915000768 |
| _version_ | 1818152976325279744 |
|---|---|
| author | Ashish K. Kannaujia Chetna Shamshery Ashish Bhowmik |
| author_facet | Ashish K. Kannaujia Chetna Shamshery Ashish Bhowmik |
| author_sort | Ashish K. Kannaujia |
| collection | DOAJ |
| description | Presence of mitral stenosis deteriorates the already compromised cardiac status of a pregnant female. Decision between regional and general anesthesia can be crucial in such cases. Our patient a 20-year-old, and primigravida scheduled for emergency cesarean section due to acute fetal distress was a diagnosed case of severe mitral stenosis and pulmonary hypertension (48 mmHg). During antenatal she was on anticoagulants and was monitored regularly. In the operation theater she was monitored for heart rate, invasive blood pressure, central venous pressure, SpO2 and urine output. We gave combined spinal epidural anesthesia (CSEA) at L3–4, using 7.5 mg 0.5% bupivacaine with 8% dextrose. Immediately after CSEA a continuous vasopressin infusion at 2–4 units/h was started, which took care of hypotension and pulmonary hypertension and it was stopped at the end of the surgery. The patient was stable hemodynamically intra and postoperatively. A baby of 2.2 kg was delivered with an APGAR score 7, 8, 9. |
| first_indexed | 2024-12-11T14:03:16Z |
| format | Article |
| id | doaj.art-61847aa4a817490c9ca9bcc487281a03 |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-12-11T14:03:16Z |
| publishDate | 2016-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-61847aa4a817490c9ca9bcc487281a032022-12-22T01:03:46ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492016-01-0132114314510.1016/j.egja.2015.07.001Vasopressin infusion during combine spinal epidural anesthesia for cesarean section in a patient with severe mitral stenosis with pulmonary hypertensionAshish K. Kannaujia0Chetna Shamshery1Ashish Bhowmik2SGPGIMS, Lucknow, Uttar Pradesh, IndiaSGPGI, Lucknow, Uttar Pradesh, IndiaDepartment of Anaesthesiology, Fortis Escorts Heart Institute, New Delhi, IndiaPresence of mitral stenosis deteriorates the already compromised cardiac status of a pregnant female. Decision between regional and general anesthesia can be crucial in such cases. Our patient a 20-year-old, and primigravida scheduled for emergency cesarean section due to acute fetal distress was a diagnosed case of severe mitral stenosis and pulmonary hypertension (48 mmHg). During antenatal she was on anticoagulants and was monitored regularly. In the operation theater she was monitored for heart rate, invasive blood pressure, central venous pressure, SpO2 and urine output. We gave combined spinal epidural anesthesia (CSEA) at L3–4, using 7.5 mg 0.5% bupivacaine with 8% dextrose. Immediately after CSEA a continuous vasopressin infusion at 2–4 units/h was started, which took care of hypotension and pulmonary hypertension and it was stopped at the end of the surgery. The patient was stable hemodynamically intra and postoperatively. A baby of 2.2 kg was delivered with an APGAR score 7, 8, 9.http://www.sciencedirect.com/science/article/pii/S1110184915000768Cesarean sectionMitral valve stenosisPulmonary arterial hypertensionSpinal anesthesiaVasopressin |
| spellingShingle | Ashish K. Kannaujia Chetna Shamshery Ashish Bhowmik Vasopressin infusion during combine spinal epidural anesthesia for cesarean section in a patient with severe mitral stenosis with pulmonary hypertension Egyptian Journal of Anaesthesia Cesarean section Mitral valve stenosis Pulmonary arterial hypertension Spinal anesthesia Vasopressin |
| title | Vasopressin infusion during combine spinal epidural anesthesia for cesarean section in a patient with severe mitral stenosis with pulmonary hypertension |
| title_full | Vasopressin infusion during combine spinal epidural anesthesia for cesarean section in a patient with severe mitral stenosis with pulmonary hypertension |
| title_fullStr | Vasopressin infusion during combine spinal epidural anesthesia for cesarean section in a patient with severe mitral stenosis with pulmonary hypertension |
| title_full_unstemmed | Vasopressin infusion during combine spinal epidural anesthesia for cesarean section in a patient with severe mitral stenosis with pulmonary hypertension |
| title_short | Vasopressin infusion during combine spinal epidural anesthesia for cesarean section in a patient with severe mitral stenosis with pulmonary hypertension |
| title_sort | vasopressin infusion during combine spinal epidural anesthesia for cesarean section in a patient with severe mitral stenosis with pulmonary hypertension |
| topic | Cesarean section Mitral valve stenosis Pulmonary arterial hypertension Spinal anesthesia Vasopressin |
| url | http://www.sciencedirect.com/science/article/pii/S1110184915000768 |
| work_keys_str_mv | AT ashishkkannaujia vasopressininfusionduringcombinespinalepiduralanesthesiaforcesareansectioninapatientwithseveremitralstenosiswithpulmonaryhypertension AT chetnashamshery vasopressininfusionduringcombinespinalepiduralanesthesiaforcesareansectioninapatientwithseveremitralstenosiswithpulmonaryhypertension AT ashishbhowmik vasopressininfusionduringcombinespinalepiduralanesthesiaforcesareansectioninapatientwithseveremitralstenosiswithpulmonaryhypertension |