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Low-dose spinal–epidural anesthesia for Cesarean section in a parturient with uncontrolled hyperthyroidism and thyrotoxic heart disease

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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.

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    Authors and Affiliations

    1. Department of Anesthesiology, West China Second Hospital, Sichuan University, Chengdu, 610041, Sichuan, People’s Republic of China

      Zhimin Liao, Yaqin Xiong & Linli Luo

    2. Key Laboratory of Obstetric Gynecologic and Pediatric Diseases and Birth Defects, Ministry of Education, Chengdu, 610041, Sichuan, People’s Republic of China

      Zhimin Liao, Yaqin Xiong & Linli Luo

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    1. Zhimin Liao
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    2. Yaqin Xiong
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    3. Linli Luo
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    Correspondence to Linli Luo.

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    The authors have no conflicts of interest.

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    Z. Liao and Y. Xiong contributed equally to this work and should be considered co-first authors.

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    Liao, Z., Xiong, Y. & Luo, L. Low-dose spinal–epidural anesthesia for Cesarean section in a parturient with uncontrolled hyperthyroidism and thyrotoxic heart disease. J Anesth 30, 731–734 (2016). https://doi.org/10.1007/s00540-016-2186-1

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    • DOI: https://doi.org/10.1007/s00540-016-2186-1

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