Abstract
An increasing number of parturients suffering from ischaemic heart disease require anaesthetic care for labour and vaginal delivery. We present the case of a 42-year-old gravida who had previously suffered a myocardial infarction and undergone coronary artery bypass grafting. Management was directed toward prevention of haemodynamic instability by alleviation of pain and stress while minimizing the risk of anaesthesic complications. Monitoring included a central venous catheter, pulse oximetry, and an automated blood pressure cuff. A judiciously administered segmental lumbar extradural block was instituted early, utilizing local anaesthetics with the narcotic fentanyl.
Résumé
Un nombre croissant de femmes enceintes souffrant de maladie cardiaque ischémique requièrent des soins anesthêsiques pour le travail et ľaccouchement. Onprésente le cas ďune femme de 42 ans ayant souffert ďun infarctus du myocarde nécessitant un pontage aortocoronarien. La conduite anesthésique a été orientée vers la prévention de ľinstabilité hémodynamique par ľabolition de la douleur et du stress et en réduisant les risques des complications anesthêsiques. Le monitorage comprenait un cathéter veineux central, un saturomètre et un sphygmomano-mêtre automatisé. Une anesthésie lombaire péridurale segmentate avait été faite au préalable avec un anesthésique local additionné de fentanyl.
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Rosenlund, R.C., Gertie F. Marx Anaesthetic management of a parturient with prior myocardial infarction and coronary artery bypass graft. Can J Anaesth 35, 515–517 (1988). https://doi.org/10.1007/BF03026903
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DOI: https://doi.org/10.1007/BF03026903