title: Continuous spinal analgesia for labor pain in a parturient with aortic stenosis.
abstract: Aortic stenosis in pregnancy carries a high fetal and maternal morbidity and mortality. Spinal analgesia/anesthesia is considered by many to be contraindicated in these patients. The rapid onset of sympathetic block induces hypotension, which can result in myocardial hypoperfusion and myocardial ischemia. We describe a case of moderate to severe aortic stenosis, diagnosed during pregnancy, in which pain relief during labor and delivery was managed using a continuous spinal catheter. Pure intrathecal opioid analgesia was used initially to maintain hemodynamic stability. However after two bolus administrations of sufentanil, analgesia was further maintained using ropivacaine and sufentanil. A spinal catheter was chosen to provide reliable anesthesia, which could be extended rapidly for cesarean section.
authors.affiliation: Department of Anesthesiology, Katholieke Universiteit Leuven, Leuven, Belgium. marc.vandevelde@uz.kuleuven.ac.be
authors.forename: M
authors.initials: M
authors.lastname: Van de Velde
authors.forename: W
authors.initials: W
authors.lastname: Budts
authors.forename: E
authors.initials: E
authors.lastname: Vandermeersch
authors.forename: B
authors.initials: B
authors.lastname: Spitz