Low dose combined spinal-epidural anaesthesia for caesarean section in a patient with peripartum cardiomyopathy.
A patient with peripartum cardiomyopathy was scheduled for elective caesarean section after stabilization on medical therapy. Wer performed a combined spinal epidural using one ml 0.5% hyperbaric bupivacaine (5 mg) with 0.3 mg diamorphine for the spinal. The epidural was topped up with 10 mL bupivacaine 0.5%. Significant haemodynamic changes consisted of reduction in heart rate and hypotension after the spinal, and tachycardia after delivery. The benefits and risks of this approach are discussed.
Pirlet
M
M
Sir Humphry Davy Department of Anaesthesia, St Michael's Hospital, Bristol, UK.
Baird
M
M
Pryn
S
S
Jones-Ritson
M
M
Kinsella
S M
SM