title: [Cesarean section in a morbidly obese parturient under epidural anesthesia].
abstract: A 26-yr-old morbidly obese parturient with a body mass index of 62 kg.m-2 underwent elective cesarean section for preeclampsia under epidural anesthesia. The distance between the skin and the epidural space was about 9 cm at the L3-4 interspace via mid approach. Epidural catheter was inserted 5 cm cephalad in the sitting position and a bolus of 17 ml of mepivacaine 1.5% was given in the supine position. The T5 level of analgesia was obtained 10 min later. Forty minutes after the start of the surgery, a female newborn weighing 3,206 g was delivered with an Apgar score 8 at 1 min and 9 at 5 min. Throughout the surgery, sufficient analgesia was obtained and any complications such as severe hypotension and respiratory depression did not develop. Postoperative pain was relieved sufficiently with a continuous epidural infusion of 0.25% bupivacaine at a rate of 0.5 ml.h-1 for two days. Both maternal and neonatal postpartum courses were uneventful. In conclusion, elective cesarean section in a morbidly obese parturient was successfully managed with epidural anesthesia. This indicates that an elective cesarean section under epidural anesthesia reduce the risk of perioperative complications in a morbidly obese parturient.
authors.affiliation: Department of Anesthesiology, Jichi Medical School, Tochigi.
authors.forename: R
authors.initials: R
authors.lastname: Konishi
authors.forename: S
authors.initials: S
authors.lastname: Akazawa
authors.forename: H
authors.initials: H
authors.lastname: Mitsuhata
authors.forename: M
authors.initials: M
authors.lastname: Hiruta
authors.forename: H
authors.initials: H
authors.lastname: Suzuki
authors.forename: K
authors.initials: K
authors.lastname: Saitoh
authors.forename: T
authors.initials: T
authors.lastname: Igarashi
authors.forename: R
authors.initials: R
authors.lastname: Shimizu
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009767:Obesity, Morbid; D011225:Pre-Eclampsia; D011247:Pregnancy; D011248:Pregnancy Complications