EPIDURAL ANESTHESIA IN PATIENT WITH EISENMENGER SYNDROME UNDERGOING CAESAREAN SECTION: SERIAL CASE REPORTS
Tresna Kusumah Natapraja, Dhanny Budipratama, Erwin Pradian, Iwan Fuadi, Suwarman, Reza W. Sudjud

Department of Anesthesiology and Intensive Care Faculty of Medicine
Padjadjaran University
Hasan Sadikin General Hospital Bandung

Abstract

Abstract
Background: Management of anesthesia in pregnant patient undergoing cesarean section with Eisenmenger syndrome.
Objective: The patient had undergone cesarean section with epidural regional anesthesia has a good outcome and cared postoperatively in Cardiac Intensive Center Unit.
Methods: This case reported patient who was admitted to the hospital with Eisenmenger syndrome, shortness of breath, bluish at the extremities with ASA III E physical status. Oxygen demand in pregnancy will increase along with gestational age, this condition can cause hypoxemia in pregnancy and the fetus. Therefore, we need to balance between pulmonary vascular resistance and systemic vascular resistance to avoid hemodynamic changes resulting in hypoxemia through the right-to-left shunt. Regional anesthesia techniques have the advantage of maintaining hemodynamics.
Result: This patient was performed cesarean section with epidural regional anesthesia in 1.5 to 2 hours of surgery with no changes in hemodynamics status and was prepared for postoperative care in Cardiac Intensive Care Unit
Conclusion: The main goal of anesthesia in patients with congenital heart defects in pregnancy is to maintain maternal and fetal hemodynamics.

Keywords: Eisenmenger syndrome, pulmonary hypertension, epidural regional anesthesia

Keywords: Eisenmenger syndrome, pulmonary hypertension, epidural regional anesthesia

Topic: Update Emergency Assesment and Management