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CASE REPORT
Year : 2019  |  Volume : 33  |  Issue : 2  |  Page : 104-107

Takayasu's arteritis: Anesthetic implications and management of a patient for cesarean section using combined spinal-epidural technique


Department of Anaesthesiology, Regional Institute of Medical Sciences, Imphal, Manipur, India

Correspondence Address:
K S H Sandeep
Department of Anaesthesiology, RIMS, Imphal, Imphal West - 795 004, Manipur
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jms.jms_32_19

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Takayasu's arteritis (TA) or pulseless disease is a rare, idiopathic, chronic granulomatous vasculitis that affects mainly aorta and its major branches. We report herewith the anesthetic management of a parturient who suffered from TA scheduled for elective cesarean section by using combined spinal-epidural technique, which offers the combined advantage of both spinal and epidural anesthesia and postoperative analgesia. Anesthesia for patients with TA is complicated by severe uncontrolled hypertension, end-organ dysfunction, stenosis of major branches of aorta, and difficulties in monitoring hemodynamic parameters. Our patient was a full-term, 29-year-old female weighing 60 kg, of height 154 cm, gravida 1, and para 0 scheduled for elective lower segment cesarean section. The intraoperative period was uneventful with minimal rise in blood pressure (BP) which was managed accordingly with antihypertensive medications. The patient was stable in the postoperative period with minor rise in BP from baseline and was shifted to ward after being monitored in the intensive care unit for 24 h.


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