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Infiltration block for caesarean section in a morbidly obese parturient
P L Gautam1, S Kathuria, T K Kaul
1Department of Anaesthesia, Dayanand Medical College & Hospital, Ludhiana, India.
Acta Anaesthesiologica Scandinavica
|May 26, 1999
Summary
A morbidly obese woman with pre-eclampsia and respiratory failure underwent an emergency caesarean section for a dead fetus. Postoperative care, including physiotherapy and oxygen, led to improvement.
Area of Science:
- Obstetrics and Gynecology
- Anesthesiology
- Critical Care Medicine
Background:
- Management of morbidly obese parturients presents unique anesthetic and surgical challenges.
- Unsupervised pregnancies in obese women increase risks for severe maternal complications like pre-eclampsia and respiratory failure.
Observation:
- A 150 kg, 150 cm parturient with an unsupervised pregnancy presented with severe pre-eclampsia, generalized edema, and acute respiratory failure.
- Emergency lower segment caesarean section was indicated due to a dead fetus.
Findings:
- The caesarean section was successfully performed under a lidocaine infiltration block (0.5-1.0%).
- Postoperative management included aggressive physiotherapy, semi-recumbent positioning, and oxygen supplementation.
Implications:
- This case highlights the successful use of infiltration anesthesia in a high-risk, morbidly obese parturient.
- Effective postoperative care strategies are crucial for improving outcomes in critically ill, obese patients undergoing caesarean delivery.