Anaesthesia for caesarean delivery in a pregnant with acute type B aortic dissection

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dc.authorscopusid22956895300
dc.authorscopusid55898201200
dc.authorscopusid52464396900
dc.authorscopusid8098620700
dc.authorscopusid55323924900
dc.authorscopusid34569135700
dc.authorscopusid7004486274
dc.contributor.authorKayhan G.E.
dc.contributor.authorGülhaş N.
dc.contributor.authorŞahin T.
dc.contributor.authorÖzgül Ü.
dc.contributor.authorŞanli M.
dc.contributor.authorDurmuş M.
dc.contributor.authorErsoy M.Ö.
dc.date.accessioned2024-08-04T20:02:06Z
dc.date.available2024-08-04T20:02:06Z
dc.date.issued2013
dc.departmentİnönü Üniversitesien_US
dc.description.abstractAbout 50% of aortic dissections in women younger than 40 years occur during pregnancy; mostly in the 3rd trimester and postpartum period. Aortic dissection in pregnancy creates a serious mortality risk for both mother and the foetus. The ultimate goal is to ensure the safety of both the mother and the foetus. In such cases, the best method of anaesthesia for caesarean delivery is still controversial. The first aim of anaesthetic management is to reduce the effect of cardiovascular instability on the dissected aorta. Here, we report anaesthetic management of a 36 year-old patient who developed acute type B aortic dissection at the 30th gestational week and whom was scheduled for caesarean section. Since haemodynamic stability could not be achieved despite nitroglycerine and esmolol infusions, together with invasive arterial monitoring, the decision for caesarean delivery was taken. A team of Cardiovascular Surgeons and an operating room were prepared because of the risks of aortic rupture and haemodynamic collapse during operation. A combined-spinal epidural anaesthesia was administered using 5 mg hyperbaric bupivacaine and 20 ?g fentanyl given at the L3-4 spinal level in the lateral position. After achieving T4 sensorial level, the operation proceeded and a baby weighing 1432 grams was delivered in 4 mins with a median sub-umbilical incision. Epidural patient controlled analgesia was applied to the patient during follow-up with medical treatment at postoperative period. Application of combined-spinal epidural anaesthesia with a combination of low dose local anaesthetics and an opioid with additional doses for insufficient sensorial levels is a suitable method for pregnant women with acute type B aortic dissection. © 2013 by Turkish Anaesthesiology and Intensive Care Society.en_US
dc.identifier.doi10.5152/TJAR.2013.27
dc.identifier.endpage181en_US
dc.identifier.issn1304-0871
dc.identifier.issue5en_US
dc.identifier.scopus2-s2.0-84886309878en_US
dc.identifier.scopusqualityN/Aen_US
dc.identifier.startpage178en_US
dc.identifier.urihttps://doi.org/10.5152/TJAR.2013.27
dc.identifier.urihttps://hdl.handle.net/11616/91427
dc.identifier.volume41en_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.relation.ispartofTurk Anesteziyoloji ve Reanimasyon Dernegi Dergisien_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAortic dissectionen_US
dc.subjectCaesarean sectionen_US
dc.subjectCombined-spinal epidural anaesthesiaen_US
dc.titleAnaesthesia for caesarean delivery in a pregnant with acute type B aortic dissectionen_US
dc.title.alternativeGebelik si{dotless}rasi{dotless}nda akut tip B aort diseksiyonu gelişen olguda sezaryen i?çin anestezi yaklaşi{dotless}mi{dotless}en_US
dc.typeArticleen_US

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