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Korean Journal of Anesthesiology 2007;52(5):605-608.
DOI: https://doi.org/10.4097/kjae.2007.52.5.605   
Combined Spinal-epidural Anesthesia for Cesarean Section in a Patient with Peripartum Cardiomyopathy: A case report.
Hee Yeon Park, Eui Kyoung Goo, Sang Hwan Do, Kum Suk Park
Department of Anesthesiology, Seoul National University College of Medicine, Seoul, Korea. pks0399@empal.com
Peripartum cardiomyopathy (PPCM) is a rare form of cardiomyopathy associated with a significant morbidity and mortality. The anesthetic management of a Cesarean section in patients with PPCM has not been well defined. Herein, our experience of a 31-year-old multipara, with recurrent PPCM and congestive heart failure, who presented for an elective cesarean section, is reported. Combined spinal-epidural anesthesia was successfully employed as the anesthetic technique for the procedure. The intra-arterial blood pressure and central venous pressure were monitored throughout the procedure. In addition, the patient's postoperative pain was markedly reduced with the use of epidural PCA. Combined spinal-epidural anesthesia is suggested to be a reliable technique, which provides minimal hemodynamic changes, and a lower failure rate than epidural anesthesia only, and is also highly effective with a low dose of local anesthetic drug.
Key Words: cesarean section; combined spinal-epidural anesthesia; peripartum cardiomyopathy
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