[Perioperative management for cesarean section in a patient with corrected transposition of the great arteries].
We report anesthetic management for cesarean section in a pregnant (36 weeks) woman with corrected transposition of the great arteries, associated with Ebstein's anomaly and atrial septal defect. She had not received any surgical procedure, and had orthopnea and chest pain which were the signs of congestive heart failure before pregnancy. Her heart failure was ongoing through 34 th week of gestation. Central venous pressure and invasive arterial pressure were monitored perioperatively. A low-dose of fentanyl (3.5 micrograms.kg-1) was injected intravenously 5 minutes before induction, followed by anesthesia induced by thiamylal and suxamethonium chloride. Continuous infusion of propofol and continuous epidural anesthesia were started after delivery, supplemented by isoflurane. No significant cardiovascular changes were observed in the mother during the operation. The infant showed no respiratory dysfunction at birth.
Kawano
Keiko
K
Department of Anesthesiology and Critical Care Medicine, Kagoshima University School of Medicine, Kagoshima 890-8520.
Tobo
Kazumi
K
Shinmura
Naomi
N
Yamaguchi
Shunichiro
S
Kitamura
Naoko
N
Yuge
Keiko
K
Tei
Chuwa
C
Kanmura
Yuichi
Y
D000328:Adult; D000767:Anesthesia, Epidural; D000768:Anesthesia, General; D000773:Anesthesia, Obstetrical; D002585:Cesarean Section; D004437:Ebstein Anomaly / Q000150:complications; D005260:Female; D006333:Heart Failure / Q000209:etiology; D006344:Heart Septal Defects, Atrial / Q000150:complications; D006801:Humans; D007231:Infant, Newborn; D019990:Perioperative Care; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011256:Pregnancy Outcome; D014188:Transposition of Great Vessels / Q000150:complications*