Use of remifentanil in a patient with peripartum cardiomyopathy requiring Caesarean section.
We describe a case of a 26 yr old primigravida at 39 weeks' gestation, with a diagnosis of peripartum cardiomyopathy, requiring urgent Caesarean section. The patient presented in severe heart failure and active labour. A general anaesthetic, using a target-controlled infusion of propofol and an intravenous infusion of remifentanil, was used to provide stable anaesthesia and analgesia for a successful delivery. The unusual diagnosis of peripartum cardiomyopathy and the potential benefits of the use of remifentanil in high-risk obstetric surgery are discussed.
McCarroll
C P
CP
Department of Clinical Anaesthesia, Royal Victoria Hospital, Belfast, UK.
Paxton
L D
LD
Elliott
P
P
Wilson
D B
DB
D000328:Adult; D000701:Analgesics, Opioid; D000771:Anesthesia, Intravenous / Q000379:methods; D000773:Anesthesia, Obstetrical / Q000379:methods*; D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D002311:Cardiomyopathy, Dilated / Q000150:complications*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D007744:Obstetric Labor Complications; D010880:Piperidines; D011247:Pregnancy; D015742:Propofol; D000077208:Remifentanil
D000701:Analgesics, Opioid; D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol