Anesthetic management for cesarean section in moyamoya disease: a report of five consecutive cases and a mini-review.
We report five consecutive cases of neuraxial anesthesia for cesarean section in women with moyamoya disease. Either epidural or combined spinal-epidural anesthesia was provided, with adequate sedation using intravenous diazepam and/or opioid(s). Hemodynamic stability and normocapnia were well maintained, except in one patient who exhibited transient hypertension and hypocapnia due to anxiety. None of the parturients suffered from neurological deficit in the intra- or postoperative period, although one patient complained of numbness in her fingers at the end of surgery, but she was not hypotensive or hypocapneic. The neonates were all in good health. The literature is reviewed on the anesthetic management for cesarean section in patients with moyamoya disease.
Kato
R
R
Division of Obstetric Anesthesia, Center for Maternal, Fetal and Neonatal Medicine, and Department of Anesthesiology, Saitama Medical Center, Japan. rie.kato@nifty.com
Terui
K
K
Yokota
K
K
Nakagawa
C
C
Uchida
J
J
Miyao
H
H
D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D001007:Anxiety / Q000150:complications; D002245:Carbon Dioxide / Q000097:blood; D002585:Cesarean Section; D003975:Diazepam; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006993:Hypnotics and Sedatives; D007231:Infant, Newborn; D009072:Moyamoya Disease / Q000150:complications* / Q000503:physiopathology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology*; D011256:Pregnancy Outcome
D006993:Hypnotics and Sedatives; D002245:Carbon Dioxide; D003975:Diazepam