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Obstetric Anesthesia
Anesthesia and Pain Medicine 2007;2(4):246-251.
Published online October 30, 2007.
Perioperative Management of a Parturient with Eisenmenger's Syndrome Undergoing Cesarean Section :A case report
Suk Young Lee, Justin Sang Ko, Jae Wook Jung, Sang Min Lee, I Seok Kang, Seung Woo Park, Cheong Rae Roh
1Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. marialee@smc.samsung.co.kr
2Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
3Department of Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
4Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
The Eisenmenger's syndrome is presented with an abnormal communication between the systemic and pulmonary circulations and a predominant right to left shunt caused by increased vascular resistance in the pulmonary circulation. The maternal mortality and morbidity rate associated with cesarean section in the presence of Eisenmenger's syndrome is very high. We report a successful anesthetic management of a patient with the Eisenmenger's syndrome who underwent emergency cesarean section under general anesthesia, which is the first case in Korea of using nitric oxide in an attempt to improve pulmonary hypertension and arterial oxygenation. In addition to the basic monitoring devices, arterial and pulmonary catheters were inserted before the anesthesia. A fall in blood pressure was immediately counteracted by the administration of norepinephrine, and loss of blood by transfusion and fluid. After the operation, patient was closely monitored at coronary care unit for 15 days and discharged 18 days after the delivery without complication.
Key Words: anesthesia, cesarean section, eisenmenger complex, general, nitric oxide


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