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Canadian Journal of Anesthesia, Vol 35, 515-517, Copyright © 1988 by Canadian Anesthesiologists' Society

ARTICLES

Anaesthetic management of a parturient with prior myocardial infarction and coronary artery bypass graft

RC Rosenlund and GF Marx
Department of Anesthesiology, Albert Einstein College of Medicine, Bronx, New York 10461.

An increasing number of parturients suffering from ischaemic heart disease require anaesthetic care for labour and vaginal delivery. We present the case of a 42-year-old gravida who had previously suffered a myocardial infarction and undergone coronary artery bypass grafting. Management was directed toward prevention of haemodynamic instability by alleviation of pain and stress while minimizing the risk of anaesthetic complications. Monitoring included a central venous catheter, pulse oximetry, and an automated blood pressure cuff. A judiciously administered segmental lumbar extradural block was instituted early, utilizing local anaesthetics with the narcotic fentanyl.




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Copyright © 1988 by the Canadian Anesthesiologists' Society.