Low-dose combined spinal-epidural anaesthesia for caesarean section in a patient with Eisenmenger's syndrome.
A 34-year-old woman (G3,P0) with Eisenmenger's syndrome and positive HIV serology presented to hospital at 16 weeks of pregnancy. She was hospitalised at 20 weeks under the care of a multidisciplinary team. At 33 weeks caesarean section was performed under low-dose combined spinal-epidural anaesthesia using a needle-through-needle technique. Over a period of 10 min, spinal anaesthesia produced a sensory block to T4 which did not alter oxygenation or blood pressure. Epidural supplementation was not required. The caesarean section proceeded uneventfully without pain or discomfort. The post-partum period was without major incident. Low-dose combined spinal-epidural techniques combine the advantages of spinal and epidural blockade; the versatility allows its use in a wide range of clinical conditions, combining effective anaesthesia with cardiovascular stability.
Parneix
M
M
Department of Anaesthesia D, Arnaud de Villeneuve Hospital, CHU Montpellier, France. m-parneix@chu-montpellier.fr
Fanou
L
L
Morau
E
E
Colson
P
P
D000328:Adult; D000767:Anesthesia, Epidural / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D002585:Cesarean Section; D004305:Dose-Response Relationship, Drug; D004541:Eisenmenger Complex / Q000150:complications*; D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000188:drug therapy; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy; D011256:Pregnancy Outcome