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
Lokvendra Budania,
Kasturba Medical College, Manipal, IN
Madhu Rao,
Kasturba Medical College, Manipal, IN
About Madhu
Assistant Professor of Anaesthesiology
Yogesh Gaude,
Kasturba Medical College, Manipal, IN
Anupam Berwal
Kasturba Medical College, Manipal, IN
About Anupam
Assistant Professor of Microbiology
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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