Key result
Low-dose spinal anesthesia with ESPB maintains stable hemodynamics without cardiopulmonary complications in severe MS parturients.
Why the study?
Severe mitral stenosis during pregnancy poses major anesthetic challenges during elective cesarean delivery, as conventional single-shot spinal anesthesia may precipitate profound hypotension.
Does low-dose segmental spinal anesthesia with erector spinae plane block and invasive monitoring provide safe anesthesia for elective cesarean delivery in parturients with severe mitral stenosis?
Case Report (n=2)
Does low-dose segmental spinal anesthesia with erector spinae plane block and invasive monitoring provide safe anesthesia for elective cesarean delivery in parturients with severe mitral stenosis?
Low-dose segmental spinal anesthesia combined with fascial plane blocks and invasive monitoring may be a safe alternative anesthetic strategy for cesarean delivery in patients with severe mitral stenosis.
Low-dose segmental spinal maintains stability in severe MS for CD; leaves open comparative safety pending prospective trials.
Severe mitral stenosis (MS) during pregnancy represents a fixed cardiac output state and poses major anesthetic challenges during elective cesarean delivery (CD). Conventional single-shot spinal anesthesia may precipitate profound hypotension in these patients. We report two high-risk parturients with severe MS, classified as New York Heart Association (NYHA) class III, who underwent elective CD. Both patients were managed using low-dose segmental spinal anesthesia supplemented with ultrasound-guided erector spinae plane block (ESPB) and invasive hemodynamic monitoring. In both cases, the procedures were completed with stable intraoperative hemodynamics and effective postoperative analgesia, without cardiopulmonary complications. The combination of segmental spinal anesthesia with regional fascial plane blocks and invasive monitoring may represent a viable alternative anesthetic strategy for elective CD in carefully selected parturients with severe MS.
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Prasad et al. (2026) conducted a case report in Severe mitral stenosis in pregnancy (n=2). Low-dose segmental spinal anesthesia with ultrasound-guided erector spinae plane block (ESPB) and invasive hemodynamic monitoring was evaluated on Intraoperative hemodynamics, postoperative analgesia, and cardiopulmonary complications. Low-dose segmental spinal anesthesia with erector spinae plane block provided stable hemodynamics and effective analgesia without cardiopulmonary complications in 2 parturients with severe MS.
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