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Case Reports

Low dose spinal anaesthesia and transversus abdominis plane block in a parturient with peripartum cardiomyopathy for caesarean section following a bloody epidural tap

Authors:

Nita Varghese ,

Kasturba Medical College, Manipal, IN
About Nita
Assistant Professor of Anaesthesiology
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Lokvendra Budania,

Kasturba Medical College, Manipal, IN
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Madhu Rao,

Kasturba Medical College, Manipal, IN
About Madhu
Assistant Professor of Anaesthesiology
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Yogesh Gaude,

Kasturba Medical College, Manipal, IN
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Anupam Berwal

Kasturba Medical College, Manipal, IN
About Anupam
Assistant Professor of Microbiology
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Abstract

Peripartum cardiomyopathy (PPCM) is a form of dilated cardiomyopathy which presents unique challenges for anaesthetic management. Here we present a case of PPCM who was given low dose spinal anaesthesia with TAP block for caesarean section which is rarely reported. A 33-year-old multigravida, 35 weeks gestation presented with PPCM with ejection fraction of 24%. Elective caesarean section was planned in view of worsening dyspnoea despite treatment. Graded epidural anaesthesia with invasive monitoring was planned but we encountered a bloody tap whilst securing the epidural catheter, hence switched to low dose spinal anaesthesia (6mg of 0.5% bupivacaine+10mcg of fentanyl). Ultrasound guided bilateral TAP block was given for post-operative analgesia. We observed that the patient had a comfortable and haemodynamically stable experience intra and post operatively. Hence a low dose spinal anaesthesia and TAP block with invasive monitoring can be opted as an anaesthetic technique in PPCM.

 

How to Cite: Varghese, N., Budania, L., Rao, M., Gaude, Y. and Berwal, A., 2019. Low dose spinal anaesthesia and transversus abdominis plane block in a parturient with peripartum cardiomyopathy for caesarean section following a bloody epidural tap. Sri Lankan Journal of Anaesthesiology, 27(1), pp.77–79. DOI: http://doi.org/10.4038/slja.v27i1.8365
Published on 06 Feb 2019.
Peer Reviewed

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