Combined spinal-epidural analgesia for laboring parturient w
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Understanding the changes in cardiovascular physiology that occur during pregnancy is important in order to optimize anesthetic management and to avoid adverse maternal and fetal outcomes. The effects of a normal gestation on the cardiovascular system are particularly significant in parturients with cardiac valvular pathology. In this paper, we discuss the anesthetic management of a laboring parturient with mitral stenosis using combined spinal-epidural labor analgesia. The patient received minimal intravenous hydration (5-10 mL/h) to avoid fluid overload and was encouraged to drink clear liquids during labor. High dose of fentanyl (20-25 µg) was injected intrathecally for initial pain control. Preservative-free morphine (0.2-0.3 mg) was then used to manage contraction-related pain while maintaining stable maternal hemodynamics on an epidural infusion. A brief literature review of the anesthetic management of parturients with mitral stenosis is also presented to compare and contrast the different combined spinal-epidural techniques and outcomes...

http://bit.ly/2sbkEn4
Like
Comment
Share