title: Low-dose spinal-epidural anesthesia for Cesarean section in a parturient with uncontrolled hyperthyroidism and thyrotoxic heart disease.
abstract: A 29-year-old woman at 34 weeks' gestation with uncontrolled hyperthyroidism and thyrotoxic heart disease was admitted to urgency Cesarean section. After preoperative sedation and good communication, low-dose spinal anesthesia (7.5 mg 0.5 % bupivacaine) combined with epidural anesthesia (6 ml 2 % lidocaine) was performed through L3-4 inter-vertebral. Opioids were given intravenously to the mother for sedation after delivery of the baby. Satisfactory anesthesia and sedation was provided during surgery. The mother and the neonate were safe and no special complication was found after surgery. Our case demonstrated that low-dose spinal anesthesia combined with epidural anesthesia with intravenous opioids can provide satisfactory anesthesia and sedation, and reduce the risk of heart failure and thyroid storm.
authors.affiliation: Department of Anesthesiology, West China Second Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.|Key Laboratory of Obstetric Gynecologic and Pediatric Diseases and Birth Defects, Ministry of Education, Chengdu, 610041, Sichuan, People's Republic of China.
authors.forename: Zhimin
authors.initials: Z
authors.lastname: Liao
authors.affiliation: Department of Anesthesiology, West China Second Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.|Key Laboratory of Obstetric Gynecologic and Pediatric Diseases and Birth Defects, Ministry of Education, Chengdu, 610041, Sichuan, People's Republic of China.
authors.forename: Yaqin
authors.initials: Y
authors.lastname: Xiong
authors.affiliation: Department of Anesthesiology, West China Second Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China. linli-luo@163.com.|Key Laboratory of Obstetric Gynecologic and Pediatric Diseases and Birth Defects, Ministry of Education, Chengdu, 610041, Sichuan, People's Republic of China. linli-luo@163.com.
authors.forename: Linli
authors.initials: L
authors.lastname: Luo
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000767:Anesthesia, Epidural / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D002045:Bupivacaine / Q000008:administration & dosage; D002585:Cesarean Section / Q000379:methods*; D005260:Female; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications; D007231:Infant, Newborn; D008012:Lidocaine / Q000008:administration & dosage; D011247:Pregnancy
chemical_list: D000701:Analgesics, Opioid; D008012:Lidocaine; D002045:Bupivacaine
keywords: Cesarean section; Combined spinal epidural anesthesia; Hyperthyroidism; Thyrotoxic heart disease