Use of remifentanil in a patient with Eisenmenger syndrome requiring urgent cesarean section.
We describe a case of 41-yr.-old multigravida at 35 weeks gestation, with a diagnosis of Eisenmenger syndrome, requiring urgent Cesarean section. The parturient had signs and symptoms of respiratory distress due to high pulmonary artery pressure, and the pregnancy was complicated by preeclampsia. A general anesthetic consisting of ketamine and etomidate and an intravenous infusion of remifentanil were used to provide stable anesthesia and analgesia for a successful delivery. The baby was delivered with high Apgar scores. The potential benefits and safety of the use of remifentanil in parturients with high pulmonary artery pressures are discussed.
Duman
Ates
A
Department of Anesthesiology and Intensive Care, Selcuk Universitesi, Tip Fakultesi, Anestezi ve Reanimasyon AD, Konya, Turkey. aduman@selcuk.edu.tr
Sarkilar
Gamze
G
Dayioglu
Mürüvvet
M
Ozden
Mine
M
Görmüs
Niyazi
N
D000328:Adult; D000773:Anesthesia, Obstetrical / Q000009:adverse effects / Q000379:methods; D019162:Anesthetics, Combined / Q000009:adverse effects / Q000627:therapeutic use; D018686:Anesthetics, Intravenous / Q000009:adverse effects / Q000627:therapeutic use; D002585:Cesarean Section / Q000379:methods*; D004541:Eisenmenger Complex / Q000150:complications*; D005045:Etomidate / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007649:Ketamine / Q000009:adverse effects / Q000627:therapeutic use; D010880:Piperidines / Q000009:adverse effects / Q000627:therapeutic use*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology; D011256:Pregnancy Outcome; D000077208:Remifentanil
D019162:Anesthetics, Combined; D018686:Anesthetics, Intravenous; D010880:Piperidines; D007649:Ketamine; D000077208:Remifentanil; D005045:Etomidate