[Primary cesarean section. Use of phenylephrine during anesthesia in a patient with hypertrophic obstructive cardiomyopathy].
We report on anaesthesia management for elective Caesarean section in a parturient woman with hypertrophic obstructive cardiomyopathy (HOCM). Special considerations for anaesthesia are associated with this condition. Women with HOCM need a closed diagnostic and therapeutic follow-up during pregnancy. Anaesthesiologists have to be aware of the cardiac peculiarities. Special risks may arise from endogenous catecholamine release during labour or from therapy with beta-adrenergic drugs for treatment of blood pressure drops or suppression of uterine contractions. Epidural anaesthesia is an appropriate anaesthesia method for Caesarean section, also in patients with HOCM. Adequate hemodynamic monitoring is essential. Phenylephrine is a pure alpha-adrenergic vasoconstrictor without inotropic effects. It is suitable for therapy of blood pressure drops induced by peripheral vasodilation.
Deiml
R
R
Abteilung für Anästhesiologie und operative Intensivmedizin, Allgemeines Krankenhaus St. Georg, Hamburg.
Hess
W
W
Bahlmann
E
E
D000328:Adult; D000767:Anesthesia, Epidural; D001794:Blood Pressure / Q000187:drug effects; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications* / Q000503:physiopathology; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007022:Hypotension / Q000188:drug therapy; D007431:Intraoperative Complications / Q000188:drug therapy; D010656:Phenylephrine / Q000627:therapeutic use*; D011247:Pregnancy; D014662:Vasoconstrictor Agents / Q000627:therapeutic use*
D014662:Vasoconstrictor Agents; D010656:Phenylephrine