Key result
Combined spinal-epidural anesthesia with phenylephrine and dobutamine maintains stable hemodynamics during cesarean in complex CHD.
Case Report (n=1)
Combined spinal-epidural anesthesia with targeted vasoactive infusions (phenylephrine and dobutamine) successfully maintained hemodynamic stability during cesarean section in a patient with a bidirectional Glenn shunt.
May inform anesthetic choices for cesarean in complex congenital heart disease; leaves open generalizability beyond this single case.
This case report describes the successful intraoperative management of a cesarean section (CS) in a 40-year-old parturient with a history of bidirectional Glenn procedure for complex single-ventricle congenital heart disease. Key anesthetic strategies included combined spinal-epidural anesthesia with low-dose ropivacaine to minimize sympathetic blockade, and the simultaneous infusion of phenylephrine (via a lower limb vein) and dobutamine (via an upper limb vein) to maintain systemic vascular resistance (SVR) and reduce pulmonary vascular resistance (PVR), respectively. Combined with non-pharmacological anxiolysis and careful positioning, this approach ensured stable hemodynamics and oxygenation for both the mother and the fetus throughout the procedure.
No takes yet. Share an insight, caveat, or question.
Chen et al. (2026) conducted a case report in Cesarean section in a parturient with a bidirectional Glenn procedure for complex single-ventricle congenital heart disease (n=1). Combined spinal-epidural anesthesia with low-dose ropivacaine and simultaneous infusion of phenylephrine and dobutamine was evaluated on Stable hemodynamics and oxygenation for both the mother and the fetus throughout the procedure. Combined spinal-epidural anesthesia with low-dose ropivacaine and simultaneous phenylephrine and dobutamine infusions ensured stable hemodynamics and oxygenation during cesarean section.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: