Thoracic segmental spinal anesthesia for cesarean section in a parturient with atrial septal defect - a case report.
TSSA in ASD patient for LSCS
DOI:
https://doi.org/10.25751/rspa.35006Keywords:
analgesia, APGAR SCORE, heart failure, pregnancy, pulmonary arterial hypertension, electrocardiogramAbstract
Background
Atrial septal defect (ASD) is a common congenital disease of the heart, and most women with ASD without coexisting PAH experience uneventful pregnancies. Anesthetic management of pregnant ASD patients presenting for lower segment cesarean section (LSCS) is challenging due to potential complications.
Case
A 30-years-old pregnant women with ASD presented for LSCS. She had a 24 mm ostium secundum ASD with left to right shunt, and mild pulmonary arterial hypertension (PAH). Thoracic segmental spinal anesthesia (TSSA) was administered at the T9-T10 intervertebral space. The surgery was uneventful and postoperative pain was managed with bilateral transversus abdominis plane (TAP) block administration and NSAIDS. Her hospital stay was uneventful and was discharged on the 4th post-operative day.
Conclusion
In conclusion, TSSA for LSCS with ASD can be a safe and effective anesthetic option, but further studies are needed to establish its clinical utility in this specific context.
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