title: Spinal anesthetic for emergency cesarean section in a parturient with uncorrected tetralogy of Fallot, presenting with abruptio placentae and gestational hypertension.
abstract: A subarachnoid block is an effective way of providing anesthesia for cesarean sections. However, it can be considered relatively contra-indicated in parturients with uncorrected tetralogy of Fallot (TOF). We report a case of a 22-year-old female patient with TOF and gestational hypertension, who presented for an emergency cesarean section for placental abruption. The surgery was successfully conducted under a spinal anesthetic with a combination of low dose bupivacaine and fentanyl. Fentanyl combined with small-dose bupivacaine in the subarachnoid space can be considered as an alternative technique to general anesthesia, in selected parturients with uncorrected TOF presenting for cesarean section, especially in cases where the risks of administering a general anesthetic are deemed high.
authors.affiliation: Department of Anesthesiology and Critical Care, JIPMER, Puducherry, India.
authors.forename: Sethuramachandran
authors.initials: S
authors.lastname: Adinarayanan
authors.affiliation: Department of Anesthesiology and Critical Care, JIPMER, Puducherry, India.
authors.forename: Satyen
authors.initials: S
authors.lastname: Parida
authors.affiliation: Department of Anesthesiology and Critical Care, JIPMER, Puducherry, India.
authors.forename: Jayaram
authors.initials: J
authors.lastname: Kavitha
authors.affiliation: Department of Anesthesiology and Critical Care, JIPMER, Puducherry, India.
authors.forename: Hemavathi
authors.initials: H
authors.lastname: Balachander
keywords: Spinal anesthetic; congenital; gestational hypertension; heart defects; obstetric; tetralogy of Fallot