Open AccessSpinal anesthetic for emergency cesarean section in a parturient with uncorrected tetralogy of Fallot, presenting with abruptio placentae and gestational hypertension
Author(s) -
S Adinarayanan,
Satyen Parida,
Kavitha Jayaram,
Hemavathi Balachander
Publication year - 2014
Publication title -
journal of anaesthesiology-clinical pharmacology/journal of anaesthesiology clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.466
H-Index - 32
eISSN - 2231-2730
pISSN - 0970-9185
DOI - 10.4103/0970-9185.137276
Subject(s) - medicine , anesthesia , bupivacaine , tetralogy of fallot , fentanyl , placental abruption , elective cesarean section , subarachnoid space , anesthetic , tetralogy , pregnancy , obstetrics , surgery , gestation , cerebrospinal fluid , heart disease , cardiology , biology , genetics
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.