ABSTRACT
We report a case of sudden shock during caesarean section under combined spinal epidural anesthesia. The patient was a 29-year-old woman. During the operation vital signs had been almost stable until a female-baby was born. But after the delivery of the placenta, the patient developed an episode of coughing and dyspnea followed by unconsciousness and bradycardia. She was given adrenaline and intubated, appearing ventricular fibrillation on a EKG. Cardiopulmonary resuscitation was immediately started and sinus rhythm returned. Hypotension followed and a small dose of adrenaline was infused for three days. She made good progress and was discharged without significant sequela. Cardiopulmonary collapse type of amniotic fluid embolism (AFE) is doubtful in this case. The necessity of rapid and appropriate treatment for emergency obstetric cases was discussed.
Subject(s)
Anesthesia, Spinal/adverse effects , Cesarean Section , Embolism, Amniotic Fluid/therapy , Shock/chemically induced , Adult , Bradycardia , Cardiopulmonary Resuscitation , Dyspnea , Embolism, Amniotic Fluid/chemically induced , Epinephrine/therapeutic use , Female , Humans , Intraoperative Complications , Parturition , Pregnancy , Vasoconstrictor Agents/therapeutic useABSTRACT
Chilaiditi syndrome is assosiated with hepatodiaphragmatic interposition of the colon and the small intestines. We anesthetized 2 patients with Chilaiditi syndrome. A 62-year-old woman with interposition of the intestine was scheduled for right femoral fibrosarcoma resection. She had been medicated for schizophrenia. Total intravenous anesthesia was induced and maintained. Another patient an 81-year-old man with interposition of the colon, was scheduled for transurethral resection of a bladder tumor. He was anesthetized with spinal anesthesia. In both cases, there was no cardiovascular complication or digestive disorder during the perioperative period.
Subject(s)
Anesthetics/therapeutic use , Chilaiditi Syndrome , Aged, 80 and over , Chilaiditi Syndrome/diagnostic imaging , Female , Humans , Male , Middle Aged , Perioperative Period , Tomography, X-Ray ComputedABSTRACT
We report anesthetic management for cesarean section in a pregnant (36 weeks) woman with corrected transposition of the great arteries, associated with Ebstein's anomaly and atrial septal defect. She had not received any surgical procedure, and had orthopnea and chest pain which were the signs of congestive heart failure before pregnancy. Her heart failure was ongoing through 34 th week of gestation. Central venous pressure and invasive arterial pressure were monitored perioperatively. A low-dose of fentanyl (3.5 micrograms.kg-1) was injected intravenously 5 minutes before induction, followed by anesthesia induced by thiamylal and suxamethonium chloride. Continuous infusion of propofol and continuous epidural anesthesia were started after delivery, supplemented by isoflurane. No significant cardiovascular changes were observed in the mother during the operation. The infant showed no respiratory dysfunction at birth.
