Key result
Combined spinal-epidural anesthesia provides adequate analgesia and hemodynamic stability during cesarean section in moyamoya disease.
Why the study?
Optimal anesthesia technique for cesarean section in parturients with moyamoya disease requires balancing analgesia and hemodynamic stability.
Case Report (n=1)
Combined spinal and epidural anesthesia with ropivacaine may be a safe and effective option for cesarean section in patients with moyamoya disease.
May support regional anesthesia in moyamoya cesarean deliveries; leaves open need for controlled studies before broader adoption.
We present the case of a parturient with moyamoya disease admitted to the hospital for elective cesarean section. Combined spinal and epidural technique was chosen because it allows better analgesia than epidural anesthesia and more hemodynamic stability than either general or spinal anesthesia. Ropivacaine was the local anesthetic of choice for the epidural portion because of the wide sensory-motor dissociation, thus preserving adequate respiration in the case of a high block.
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Abouleish et al. (1998) conducted a case report in Moyamoya disease (n=1). Combined spinal and epidural anesthesia was evaluated. Combined spinal and epidural anesthesia with ropivacaine provided adequate analgesia and hemodynamic stability for a parturient with moyamoya disease undergoing elective cesarean section.
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