Key result
General anaesthesia with epidural analgesia enables safe emergency laparotomy in a 15-year-old with Eisenmenger syndrome.
Why the study?
Anaesthetic management of patients with Eisenmenger syndrome undergoing surgery is challenging due to the need to maintain cardiac output and avoid factors increasing right to left shunt.
Case Report (n=1)
No
General anaesthesia combined with patient-controlled epidural analgesia can be successfully used for emergency laparotomy in patients with Eisenmenger syndrome.
Supports feasibility of GA with PCEA for emergency surgery in Eisenmenger syndrome; hypothesis-generating and requires prospective validation before practice change.
The ES (Eisenmenger syndrome) consists of pulmonary hypertension with a reversed or bidirectional shunt at the atrio-ventricular or aorto-pulmonary level. Anaesthetic management for these patients is always challenging. So careful circulatory and respiratory managements is required to avoid various factors related to surgery and anesthesia that can potentially increase right to left shunt. So primary goal is to maintain cardiac output to prevent a decrease in systemic vascular resistance and an increase in pulmonary vascular resistance. Here we describe an anaesthetic management of a 15-year-old lady,diagnosed with ES posted for emergency removal of left adnexal mass. In this case we have used general anaesthesia with patient controlled epidural analgesia for abolishing postoperative pain.
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Kumar et al. (2019) conducted a case report in Eisenmenger syndrome (n=1). General anaesthesia with patient controlled epidural analgesia was evaluated. General anaesthesia combined with patient-controlled epidural analgesia was successfully used for emergency laparotomy in a 15-year-old female with Eisenmenger syndrome.
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