Takayasu aortoarteritis with dilated cardiomyopathy: anesthetic management of labor analgesia.
Takayasu aortoarteritis in a pregnant patient is often associated with severe life-threatening complications. The coexistence of associated dilated cardiomyopathy can further complicate the pregnancy, particularly during parturition and at the time of delivery. We describe the management of labor analgesia in a symptomatic parturient suffering from advanced Takayasu aortoarteritis with dilated cardiomyopathy and a recent episode of congestive cardiac failure. The patient was man-aged with graded epidural analgesia instituted early in labor. Intermittent boluses of 0.0625% bupivacaine with 2 microg/mL fentanyl were administered epidurally, which provided adequate analgesia without impaired hemodynamic status.
Sinha
Renu
R
Department of Anesthesiology and Intensive Care, All India Institute of Medical Sciences, New Delhi, India. renuagarwal4@rediffmail.com
Rewari
Vimi
V
D000328:Adult; D015360:Analgesia, Epidural / Q000379:methods*; D016362:Analgesia, Obstetrical / Q000379:methods*; D002311:Cardiomyopathy, Dilated / Q000150:complications*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications; D013625:Takayasu Arteritis / Q000150:complications*