Combination of low-dose spinal anesthesia and epidural anesthesia as anesthetic management in patient with uncorrected Double Outlet Right Ventricle (DORV) underwent cesarean section

Ann Card Anaesth. 2022 Oct-Dec;25(4):518-521. doi: 10.4103/aca.aca_315_20.

Abstract

Pregnant patients with uncorrected Double Outlet Right Ventricle (DORV) undergoing cesarean section are challenging for anesthesiologists. We present a case of a 24-year-old woman with a gestational age of 30-32 weeks with DORV, ventricular septal defect, pulmonary hypertension, and stage C functional class III heart failure who was successfully managed using a combination of low-dose spinal anesthesia bupivacaine 0.5% 7.5 mg with adjuvant fentanyl 50 mcg and epidural ropivacaine 0.2%, and fentanyl 50 mcg TV 10 cc given 30 minutes after the birth of her baby. Hemodynamics was stable after low-dose spinal anesthesia and until the end of the operation.

Keywords: Cesarean section; DORV; epidural anesthesia; low-dose spinal anesthesia.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anesthesia, Epidural*
  • Anesthesia, Obstetrical*
  • Anesthesia, Spinal*
  • Anesthetics, Local
  • Bupivacaine
  • Cesarean Section
  • Double Outlet Right Ventricle* / complications
  • Double Outlet Right Ventricle* / surgery
  • Female
  • Fentanyl
  • Humans
  • Infant
  • Pregnancy
  • Ropivacaine
  • Young Adult

Substances

  • Anesthetics, Local
  • Ropivacaine
  • Fentanyl
  • Bupivacaine