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Continuous spinal analgesia for labor and delivery in a parturient with hypertrophic obstructive cardiomyopathy
Author(s) -
Okutomi T.,
Kikuchi S.,
Amano K.,
Okamoto H.,
Hoka S.
Publication year - 2002
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.2002.t01-1-460317.x
Subject(s) - medicine , fentanyl , anesthesia , obstructive cardiomyopathy , pulse oximetry , pregnancy , cardiology , hypertrophic cardiomyopathy , biology , genetics
Induction of labor under analgesia was planned for a 30‐year‐old‐primiparous patient with hypertrophic obstructive cardiomyopathy (HOCM), as her fetal evaluation revealed intrauterine growth restriction at 38 weeks' gestation. However, regional analgesia during labor may present a potential risk for hemodynamic instability in patients with HOCM due to the possibility of a sympathetic block, as a result of vasodilation associated with the administration of local anesthesia. This case report demonstrates the successful management of the patient with analgesia provided by a continuous spinal catheter dosed with a continuous infusion of fentanyl and supplemental meperidine. Fetal surveillance monitoring included fetal pulse oximetry in addition to conventional cardiotocography, on the basis of which cesarean section was avoided.