Top

Published in:

Open Access 01-12-2022 | Spinal Anesthesia | Case report

Anesthetic management of cesarean section in a patient with Takayasu’s arteritis: a case report

Authors: Taichi Ando, Makoto Sumie, Shoichi Sasaki, Miho Yoshimura, Keiko Nobukuni, Jun Maki, Katsuyuki Matsushita, Kazuhiro Shirozu, Midoriko Higashi, Ken Yamaura

Published in: JA Clinical Reports | Issue 1/2022

Abstract

Background

Takayasu’s arteritis (TA) is a chronic, progressive, inflammatory arteritis. We presented the case of cesarean section in a patient with TA.

Case presentation

A 31-year-old pregnant woman with TA underwent a planned cesarean section at 34 weeks of pregnancy. She had stenosis of the cerebral and coronary arteries and heart failure due to aortic regurgitation. Spinal anesthesia was performed. In addition to standard monitoring, arterial blood pressure in the dorsalis pedis artery and regional cerebral tissue oxygen saturation were monitored. Intraoperative arterial blood pressure was maintained using continuous infusion of noradrenaline with a careful intermittent bolus infusion of phenylephrine. All the procedures were successfully performed without significant complications.

Conclusions

In a pregnant woman with TA, severe stenosis of the cerebral and coronary arteries, and heart failure due to valvular heart disease, careful anesthetic management by selecting catecholamines and assessing the perfusion pressure for critical organs is important.

Gatto M, Iaccarino L, Canova M, Zen M, Nalotto L, Ramonda R, et al. Pregnancy and vasculitis: a systematic review of the literature. Autoimmun Rev. 2012;11:A447–59. https://doi.org/10.1016/j.autrev.2011.11.019.CrossRefPubMed

Ioscovich A, Gislason R, Fadeev A, Grisaru-Granovsky S, Halpern S. Peripartum anesthetic management of patients with Takayasu’s arteritis: case series and review. Int J Obstet Anesth. 2008;17:358–64. https://doi.org/10.1016/j.ijoa.2007.12.001.CrossRefPubMed

Dutta B, Pandey R, Darlong V, Garg R. Low-dose spinal anaesthesia for a parturient with Takayasu’s arteritis undergoing emergency caesarean section. Singap Med J. 2010;51:e111–3.

Gautam S, Srivastava VK, Kumar S, Wahal R. Successful low-dose spinal anaesthesia for lower segment caesarean section in a patient with Takayasu arteritis. BMJ Case Rep. 2013;2013:bcr2013010107. https://doi.org/10.1136/bcr-2013-010107.CrossRefPubMedPubMedCentral

Lee EH, Choi E, Ahn W. Application of cerebral oximetry for a parturient with Takayasu’s arteritis undergoing cesarean section -a case report. Korean J Anesthesiol. 2013;65:158–62. https://doi.org/10.4097/kjae.2013.65.2.158.CrossRefPubMedPubMedCentral

Xiao W, Wang T, Fu W, Wang F, Zhao L. Regional cerebral oxygen saturation guided cerebral protection in a parturient with Takayasu’s arteritis undergoing cesarean section: a case report. J Clin Anesth. 2016;33:168–72. https://doi.org/10.1016/j.jclinane.2016.02.036.CrossRefPubMed

Kassa MW, Benti TM, Bedada AG. Successful spinal anaesthesia for caesarean section in an African patient with Takayasu’s arteritis. Pan Afr Med J. 2018;30:281. https://doi.org/10.11604/pamj.2018.30.281.16182.CrossRefPubMedPubMedCentral

Varghese K, Swain A, Sahu S, Mohanty P, Shukla R. Combined spinal-epidural anaesthesia for caesarean delivery in Takayasu’s arteritis: a viable alternative. Cureus. 2021;13:e12459. https://doi.org/10.7759/cureus.12459.CrossRefPubMedPubMedCentral

Gupta D, Arora N. Takayasu arteritis: anaesthetic implications in caesarean section. J Clin Anesth. 2019;58:18–9. https://doi.org/10.1016/j.jclinane.2019.04.025.CrossRefPubMed

10.

Horlocker TT, Vandermeuelen E, Kopp SL, Leffert LR, Benzon HT. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy. Reg Anesth Pain Med. 2018;43:263–309.CrossRef

11.

Fitzgerald JP, Fedoruk KA, Jadin SM, Carvalho B, Halpern SH. Prevention of hypotension after spinal anaesthesia for caesarean section: a systematic review and network meta-analysis of randomized controlled trials. Anaesthesia. 2020;75:109–21. https://doi.org/10.1111/anae.14841.CrossRefPubMed

12.

Sharkey AM, Siddiqui N, Downey K, Ye XY, Guevara J, Carvalho JCA. Comparison of intermittent intravenous boluses of phenylephrine and norepinephrine to prevent and treat spinal-induced hypotension in cesarean deliveries: randomized controlled trial. Anesth Analg. 2019;129:1312–8. https://doi.org/10.1213/ANE.0000000000003704.CrossRefPubMed

13.

Hasanin A, Amin S, Refaat S, Habib S, Zayed M, Abdelwahab Y, et al. Norepinephrine versus phenylephrine infusion for prophylaxis against post-spinal anaesthesia hypotension during elective cesarean delivery: a randomized controlled trial. Anaesth Crit Care Med. 2019;38:601–7. https://doi.org/10.1016/j.accpm.2019.03.005.CrossRef

14.

Ferguson-Myrthil N. Vasopressor use in adult patients. Cardiol Rev. 2012;20:153–8. https://doi.org/10.1097/CRD.0b013e31824e2294.CrossRefPubMed

15.

Singh PM, Singh NP, Reschke M, Ngan Kee WD, Palanisamy A, Monks DT. Vasopressor drugs for the prevention and treatment of hypotension during neuraxial anaesthesia for caesarean delivery: a Bayesian network meta-analysis of fetal and maternal outcomes. Br J Anaesth. 2020;124:e95–107. https://doi.org/10.1016/j.bja.2019.09.045.CrossRefPubMed

16.

Ngan Kee WD, Lee SWY, Ng FF, Lee A. Norepinephrine or phenylephrine during spinal anaesthesia for caesarean delivery: a randomised double-blind pragmatic non-inferiority study of neonatal outcome. Br J Anaesth. 2020;125:588–95. https://doi.org/10.1016/j.bja.2020.05.057.CrossRefPubMed

Title: Anesthetic management of cesarean section in a patient with Takayasu’s arteritis: a case report
Authors: Taichi Ando
Makoto Sumie
Shoichi Sasaki
Miho Yoshimura
Keiko Nobukuni
Jun Maki
Katsuyuki Matsushita
Kazuhiro Shirozu
Midoriko Higashi
Ken Yamaura
Publication date: 01-12-2022
Publisher: Springer Berlin Heidelberg
Keywords: Spinal Anesthesia
Sectio Caesarea
Sectio Ceasarea
Arteritis
Peridural Anesthesia
Heart Failure
Published in: JA Clinical Reports / Issue 1/2022
Electronic ISSN: 2363-9024
DOI: https://doi.org/10.1186/s40981-021-00494-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Anesthetic management of cesarean section in a patient with Takayasu’s arteritis: a case report

Abstract

Background

Case presentation

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Case presentation

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2022

Venous cannula occlusion during cardiopulmonary bypass recognized by ultrasonography of the internal jugular vein

A case of severe sciatica caused by a lymphocele after renal transplantation

A case of afterload mismatch associated with shivering leading to fatal hypoxia in a COVID-19 patient

Obstructive shock due to tracheal perforation following long-term placement of a tracheostomy tube in a pediatric patient: a case report

General anesthesia with remimazolam for a pediatric patient with MELAS and recurrent epilepsy: a case report

Bedside insertion of a peripherally inserted central catheter into a patient with BMI of 84.8 kg/m2 using a magnetic tracking and electrocardiogram-based tip confirmation system: a case report