title: Low-dose sequential combined spinal-epidural: an anaesthetic technique for caesarean section in patients with significant cardiac disease.
abstract: In the United Kingdom, cardiac disease is the second most common cause of all maternal deaths. The best anaesthetic technique for caesarean section in these patients has yet to be established. We describe a low-dose combined spinal-epidural technique in four high-risk obstetric patients who presented to this unit. Invasive monitoring was used in each case, and drugs with significant cardiovascular effects were avoided or used with extreme caution. Multidisciplinary team involvement, including serial echocardiography in the antenatal period, is strongly recommended.
authors.affiliation: Department of Anaesthesia, Queen Charlotte's & Chelsea Hospital, London, UK.
authors.forename: E L
authors.initials: EL
authors.lastname: Hamlyn
authors.forename: C A
authors.initials: CA
authors.lastname: Douglass
authors.forename: F
authors.initials: F
authors.lastname: Plaat
authors.forename: J A
authors.initials: JA
authors.lastname: Crowhurst
authors.forename: G M
authors.initials: GM
authors.lastname: Stocks
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D002585:Cesarean Section; D005260:Female; D006331:Heart Diseases; D006801:Humans; D007430:Intraoperative Care; D016343:Monitoring, Intraoperative; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular