Anesthetic management for cesarean section in two parturient with ascending aortic aneurysm: A case-based discussion

Ana Vuzdar Trajkovski, Department of Anesthesiology, Perioperative Management and Intensive Care in Gynecology and Obstetrics, Clinic of Anesthesiology, Reanimatology, Intensive Care and Pain Therapy, University Clinical Hospital Centre Zagreb, Kišpatićeva 12, Zagreb, 10000, Croatia.
Krešimir Reiner, Department of Anesthesiology, Perioperative Management and Intensive Care in Gynecology and Obstetrics, Clinic of Anesthesiology, Reanimatology, Intensive Care and Pain Therapy, University Clinical Hospital Centre Zagreb, Kišpatićeva 12, Zagreb, 10000, Croatia.
Nikolina Džaja, Department of Anesthesiology, Perioperative Management and Intensive Care in Gynecology and Obstetrics, Clinic of Anesthesiology, Reanimatology, Intensive Care and Pain Therapy, University Clinical Hospital Centre Zagreb, Kišpatićeva 12, Zagreb, 10000, Croatia.
Gloria Mamić, Department of Anesthesiology, Perioperative Management and Intensive Care in Gynecology and Obstetrics, Clinic of Anesthesiology, Reanimatology, Intensive Care and Pain Therapy, University Clinical Hospital Centre Zagreb, Kišpatićeva 12, Zagreb, 10000, Croatia.
Mirabel Mažar, Department of Anesthesiology and Intensive Care in Cardiac and Vascular Surgery, Clinic of Anesthesiology, Reanimatology, Intensive Care and Pain Therapy, University Clinical Hospital Centre Zagreb, Kišpatićeva 12, Zagreb, 10000, Croatia.
Jasminka Peršec, Clinic of Anesthesiology, Reanimatology and Intensive Care Medicine, University Clinical Hospital Dubrava, Avenija Gojka Šuška 6, Zagreb, 10000, Croatia.
Vicko Gluncic, Advocate Health - Midwest
Anita Lukic, Department of Anesthesia, Intensive Medicine, and Reanimation, Varazdin General Hospital, 1 I. Mestrovica Street, Varazdin, 42 000, Croatia. lukic.anita@yahoo.com.

Affiliations

Advocate Illinois Masonic Medical Center

Abstract

Background:The anesthetic management of parturients with ascending aortic aneurysm for cesarean section can be particularly challenging, primarily because of increased risk for aortic dissection or aneurysm rupture.

Case presentation:We present some aspects of the anesthetic management of two parturients with ascending aortic aneurysm for cesarean sections; amongst, the use of remifentanil with its effects on patient and newborn. We emphasize the importance of a cardio-obstetric team in the context of preoperative planning of such patients. Also, we reviewed some literature on the anesthetic management with its effect on peri-operative hemodynamic stability.

Conclusion:Maintaining hemodynamic stability is paramount in the prevention of the rupture or dissection of ascending aortic aneurysm during labor of parturient.

Document Type

Article

PubMed ID

38711027

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