Anestesia espinal a través de catéter para cesarea en una mujer con estenosis valvular aórtica severa

Información del artículo

RESUMEN

Se presenta el caso de una paciente de 32 años y 34 semanas de gestación con antecedentes de estenosis aórtica severa quien es programada para cesárea. Venía presentando síntomas progresivos (disnea y síncope) por lo que se había intentado una valvuloplastia con balón con resultado insatisfactorio. La anestesia para el procedimiento fue espinal continua con catéter utilizando 3.75mg de bupivacaina hiperbárica al 0.5%, 25 mcg de fentanil y 100 mcg de morfina con monitorización invasiva de presión arterial y gasto cardiaco. No se presentaron complicaciones maternas o fetales durante el perioperatorio. Con la experiencia reportada y la revisión de la literatura, sugerimos que las técnicas anestésicas neuroaxiales son una buena alternativa a la anestesia general en pacientes embarazadas con estenosis valvular aórtica severa.

Palabras clave:

Estenosis aórtica

cesárea

anestesia espinal continua

SUMMARY

It is the case of a patient 32years- old and 34weeks of gestation with antecedents of severe aortic stenosis that is programmed for caesarean section. She has been displaying progressive symptoms (dyspnea and síncope) reason why she had tried an aortic valvuloplasty with balloon without satisfactory result. The anesthesia for the procedure was spinal continuous through catheter using 3,75 mgs of 0.5% hyperbaric bupivacaina, 25 mcg of fentanyl and 100 mcg morphine, with invasive monitoring of arterial blood pressure and cardiac output. Perioperative maternal or fetal complications did not appear. With this report and the revision of literature, we suggest that the neuroaxial anesthetic techniques are a good alternative to the general anesthesia in pregnated patients with severe aortic valvular stenosis.

Key words:

Aortic stenosis

caesarean section

continuous spinal anesthesia

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