Canadian Journal of Anesthesia

, Volume 51, Issue 10, pp 993–996 | Cite as

Spinal anesthesia for Cesarean section in a parturient with long QT syndrome

Obstetrical and Pediatric Anesthesia

Abstract

Purpose

To report the first use of spinal anesthesia for Cesarean section (CS) in a parturient with a long QT syndrome (LQTS) and an automatic implantable cardiac defibrillator (AICD). Although both general and epidural anesthesia have been described for CS in patients with LQTS, there are no previous case reports on the use of spinal anesthesia. The clinical features, diagnosis, treatment and anesthetic management of LQTS are discussed.

Clinical features

A 31-yr-old woman, gravida 2 para 1 known to have LQTS and an AICD, presented in labour at 35 weeks gestation, three weeks before her scheduled CS. Her previous delivery by CS under spinal anesthesia at our institution was uneventful. On this occasion, we elected to administer spinal anesthesia because she was asymptomatic (no arrhythmia or cardiac arrest) for the last few years, was hemodynamically stable, and had received uneventful spinal anesthesia before.

Conclusion

Spinal anesthesia was used safely for CS in this parturient with LQTS.

La rachianesthésie pour une césarienne chez une parturiente qui présente un syndrome du QT long

Résumé

Objectif

Présenter le premier usage de rachianesthésie pour une césarienne chez une parturiente atteinte du syndrome du QT long (SQTL) et porteuse d’un défibrillateur cardiaque automatique implantable (DCAI). On a déjà décrit l’usage d’anesthésie générale et péridurale pour la césarienne de patientes atteintes du SQTL, mais non celui de la rachianesthésie dans ce cas. Les caractéristiques cliniques, le diagnostic, le traitement et la prise en charge anesthésique du SQTL sont discutés.

Éléments cliniques

Une femme de 31 ans, secondigeste et primipare, connue pour avoir le SQTL et porteuse d’un DCAI, s’est présentée en travail à 35 semaines de grossesse, trois semaines avant la césarienne prévue. Son accouchement précédent par césarienne sous rachianesthésie s’était bien déroulé. Nous avions alors choisi d’administrer une rachianesthésie parce que la patiente était asymptomatique (pas d’arythmie ou d’arrêt cardiaque) depuis quelques années, présentait une hémodynamique stable et avait déjà reçu une rachianesthêsie sans incident.

Conclusion

La rachianesthêsie a été utilisée de façon sécuritaire pour la césarienne chez une patiente atteinte du SQTL.

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Copyright information

© Canadian Anesthesiologists 2004

Authors and Affiliations

  • Abdulrahman Al-Refai
    • 1
  • Vit Gunka
    • 1
  • Joanne Douglas
    • 1
  1. 1.Department of AnesthesiaBC Women’s HospitalVancouverCanada

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