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Spinal anesthesia for Cesarean section in a parturient with long QT syndrome

[La rachianesthésie pour une césarienne chez une parturiente qui présente un syndrome du QT long]

From the Department of Anesthesia, BC Women’s Hospital, Vancouver, British Columbia, Canada.

Address correspondence to: Dr. Vit Gunka, Department of Anesthesia, BC Women’s Hospital, 4500 Oak Street, Vancouver, BC V6H 3N1, Canada. Phone: 604-875-2158; Fax: 604-875-2733; E-mail: vgunka{at}cw.bc.ca

Purpose: To report the first use of spinal anesthesia for Cesarean section (CS) in a parturient with a long QT syndrome (LQTS) and an automatic implantable cardiac defibrillator (AICD). Although both general and epidural anesthesia have been described for CS in patients with LQTS, there are no previous case reports on the use of spinal anesthesia. The clinical features, diagnosis, treatment and anesthetic management of LQTS are discussed.

Clinical features: A 31-yr-old woman, gravida 2 para 1 known to have LQTS and an AICD, presented in labour at 35 weeks gestation, three weeks before her scheduled CS. Her previous delivery by CS under spinal anesthesia at our institution was uneventful. On this occasion, we elected to administer spinal anesthesia because she was asymptomatic (no arrhythmia or cardiac arrest) for the last few years, was hemodynamically stable, and had received uneventful spinal anesthesia before.

Conclusion: Spinal anesthesia was used safely for CS in this parturient with LQTS.

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