This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Okutomi, T. Articles by Hoka, S. Search for Related Content PubMed PubMed Citation Articles by Okutomi, T. Articles by Hoka, S.

Labour analgesia guided by echocardiography in a parturient with primary dilated cardiomyopathy

[L’analgésie guidée par échocardiographie pendant le travail chez une parturiente atteinte d’insuffisance cardiaque primitive]

Toshiyuki Okutomi, MD^*, Miwako Saito, MD^*, Kan Amano, MD, Keiko Fukuoka, MT and Sumio Hoka, MD^*

^* From the Departments of Anesthesiology, and
Obstetrics, and
the Division of Clinical Laboratory, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.

Address correspondence to: Dr. Toshiyuki Okutomi, Department of Anesthesiology, Kitasato University, 1-15-1 Kitasato, Sagamihara, Kanagawa 228-8555, Japan. Phone: +81-42-778-8606; Fax: +81-42-778-8441; E-mail: toshiyukiokutomi{at}hotmail.com

Purpose: To evaluate the effects of intrathecal analgesics on cardiac function during labour analgesia using echocardiography in a parturient with idiopathic dilated cardiomyopathy (DCM).

Clinical features: Induction of labour was planned in a 35-yr-old primiparous woman suffering from DCM. In order to stabilize hemodynamics in this patient, we induced continuous spinal analgesia with an infusion of fentanyl and epinephrine. Although her analgesia was well maintained for three hours during the first stage of labour, the patient complained of pain towards the second stage of labour. At this point, we administered bupivacaine intrathecally to alleviate her pain. Transthoracic echocardiography showed that the left ventricular end-diastolic and systolic dimensions, as well as the ejection fraction were not impaired by use of these analgesic medications.

Conclusion: Measurement of left ventricular dimensions by echocardiography allowed us to monitor the patient’s response to intrathecal analgesic medications. In this patient with DCM, analgesia with intrathecal fentanyl and bupivacaine was well tolerated.

This article has been cited by other articles:

				R. Preston Challenges in obstetric anesthesia and analgesia Can J Anesth, June 1, 2008; 55(6): 386 - 389. [Full Text] [PDF]