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Canadian Journal of Anaesthesia

, Volume 37, Issue 6, pp 685–688 | Cite as

Alfentanil for urgent Caesarean section in a patient with severe mitral stenosis and pul-monary hypertension

  • Mark A. Batson
  • Stephen Longmire
  • Eileen Csontos
Clinical Reports

Abstract

We present the case of a parturient with severe mitral stenosis and pulmonary hypertension who received general anaesthesia using alfentanil for urgent Caesarean section. Alfentanil promoted haemodynamic stability and allowed immediate postoperative extubation. Epidural morphine provided postoperative analgesia. This combination permitted early ambulation and prevention of thromboembolism. A disadvantage of this technique, neontal respiratory depression, was promptly reversed with a single dose ofnaloxone. The anaesthetic management of mitral stenosis in pregnancy is discussed and the neonatal pharmacokinetics of maternally administered alfentanil are presented.

Key words

Anaesthesia: obstetrical, Caesarean section Anaesthetics: intravenous, alfentanil Heart: mitral stenosis 

Résumé

On présente le cas d’une parturiente atteinte d’une sténose mitrale sévire et hypertension pulmonaire avant subi l’anesthésie générale avec de l’alfentanil pour une césarienne d’urgence. L’alfentanil a favorise la stabilité hémodynamique et a permis une extubation rapide. La morphine en administration épidurale afourni l’analgésie postopératoire. Cette combinaison a permis une mobilisation précoce et la prévention de l’embolie. Le désavantage de cette technique, la dépression respiratoire néonatale, a été rapidement antagonisé par une dose unique de naloxone. La conduite anesthésique de la grossesse chez les femmes atteintes d’une sténose mitrale est discutée et la pharmacocinétique néonatale et maternelle de l’alfentanil est présenée.

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Copyright information

© Canadian Anesthesiologists 1990

Authors and Affiliations

  • Mark A. Batson
    • 1
  • Stephen Longmire
    • 1
  • Eileen Csontos
    • 1
  1. 1.Department of AnesthesiologyBaylor College of MedicineHouston

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