An Anesthetic Management of Emergency Caesarean Section through Low-Dose Sequential Combined Spinal-Epidural Blockade with Maternal Wolff-Parkinson-White Syndrome

Wolff-Parkinson-White (WPW) syndrome is a rare conduction system disorder of the heart that the abnormal accessory conduction pathway is located in between the atriums and ventricles.The anesthetic management of WPW syndrome patients is challenging because it can cause life threatening complication such as paroxysmal supraventricular tachycardia (PSVT) or atrial fibrillation.However, the most effective anesthetic management of WPW syndrome patient has not well been reported.The authors faced a WPW pregnant patient who requires emergency caesarean section due to fetal destress, and considered epidural anesthesia for rapid onset as emergency condition.We performed low-dose sequential combined spinal-epidural blockade (CSE) for anesthesia.Spinal anesthesia was performed with less than conventional dose due to hemodynamic stability, and additional local anesthetic injection through the epidural catheter.We describe a case of WPW patient who had emergency cesarean section and review the anesthetic management of WPW syndrome.