[Cesarean section in a patient with cerebral ischemic pathology. Spinal anesthesia].
The choice of anaesthesia for Caesarean sections, in patient with recent cerebral ischemic-hemorrhagic injuries, is a big problem. A case is reported of a woman submitted to Caesarean section in spinal anaesthesia who, in the first quarter, suffered an ischemic-hemorrhagic cerebral injury. Spinal anaesthesia was made by hyperbaric bupivacaine 0.5% at 10 mg dose + fentanyl 25 micrograms using 24G Sprotte needle. Spinal anaesthesia guarantees a good neuroendocrine protection to surgical aggression and a good hemodynamic stability. Hypotension prophylaxis by pre-filled is necessary and its treatment with ephedrine must be timely carried out. Risk of post-dural puncture headache, by atraumatic and very thin needles, is negligible. Spinal anaesthesia avoids general anaesthesia which may cause cardiovascular damages due to oro-tracheal intubation leading to possible cerebral damage. Induction-delivery time is more dangerous: the use of alogenate, oppioids, and/or some medicaments which may control the mother's adrenergic response, exhibit the newborn to risks.
Caputo
F
F
Servizio Anestesia e Rianimazione, Ospedale N. Melli, San Pietro Vernotico, Brindisi.
D000328:Adult; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D002545:Brain Ischemia / Q000150:complications*; D002543:Cerebral Hemorrhage / Q000150:complications*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D011247:Pregnancy
Taglio cesareo in paziente con patologia ischemica cerebrale. Anestesia spinale.