Key result
Low-dose sequential combined-spinal epidural anesthesia maintains cardiovascular stability during Cesarean section in a TOF patient.
Why the study?
Does low-dose sequential combined-spinal epidural anesthesia provide safe and adequate anesthesia in a parturient with uncorrected tetralogy of Fallot undergoing Cesarean section?
Case Report (n=1)
No
Does low-dose sequential combined-spinal epidural anesthesia provide safe and adequate anesthesia in a parturient with uncorrected tetralogy of Fallot undergoing Cesarean section?
Low-dose sequential combined-spinal epidural anesthesia may be a safe and effective alternative for parturients with uncorrected tetralogy of Fallot undergoing Cesarean section.
May support use in select uncorrected TOF cases; leaves open need for prospective validation before broader adoption.
Tetrology of Fallot (TOF) is the most commonly encountered congenital cardiac lesion in pregnancy. Although there are controversies regarding safe anesthetic technique for parturient with TOF, we use low-dose sequential combined-spinal epidural anesthesia in such a case posted for Cesarean section and found that low dose (0.5 ml of 0.5%) intrathecal bupivacaine and fentanyl with sequential epidural bupivacaine supplementation was adequate for the performance of an uncomplicated Cesarean section with minimal side effects and good fetal outcome. Thus, though the choice of anesthesia can vary in such patients, low-dose sequential combined-spinal epidural can be a safe alternate to achieve good anesthesia with impressive cardiovascular stability.
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Solanki et al. (2011) conducted a case report in Uncorrected tetralogy of Fallot in pregnancy (n=1). Low-dose sequential combined-spinal epidural anesthesia was evaluated on Adequacy of anesthesia, side effects, fetal outcome, and cardiovascular stability. Low-dose sequential combined-spinal epidural anesthesia provided adequate anesthesia with impressive cardiovascular stability and minimal side effects for Cesarean section in a patient with TOF.
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