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Congenital complete heart block and spinal anaesthesia for caesarean section

A Umesh Kumar1, R Sripriya, S Parthasarathy

  • 1Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Puduchery, India.

Indian Journal of Anaesthesia
|April 25, 2012
PubMed

Insights

Congenital complete heart block can be asymptomatic. Early recognition and careful anesthetic management, including a bupivacaine-fentanyl combination and temporary pacing, are crucial for hemodynamic stability and heart rate control during surgery.

Area of Science:

  • Cardiology
  • Anesthesiology
  • Obstetrics

Background:

  • Congenital complete heart block (CCHB) can present asymptomatically, posing diagnostic challenges.
  • Patients with CCHB are at risk for sudden cardiac death.
  • Peri-operative anesthetic management aims to maintain heart rate and hemodynamic stability.

Purpose of the Study:

  • To present a case of CCHB in a patient undergoing an elective cesarean section.
  • To highlight effective anesthetic strategies for managing CCHB during surgery.
  • To emphasize the importance of peri-operative heart rate control and hemodynamic stability.

Main Methods:

  • Case report of a patient with CCHB undergoing cesarean section.
  • Anesthetic management utilizing a bupivacaine-fentanyl combination.
  • Peri-operative monitoring and use of a temporary pacemaker.

Main Results:

  • The bupivacaine-fentanyl combination effectively maintained hemodynamic stability.
  • Peri-operative heart rate was adequately controlled with the chosen anesthetic and temporary pacing.
  • The patient tolerated the elective cesarean section without major complications.

Conclusions:

  • Congenital complete heart block requires vigilant anesthetic planning.
  • A bupivacaine-fentanyl combination can be advantageous for hemodynamic and heart rate control.
  • Temporary pacing is a valuable tool in managing CCHB during surgical procedures.

Keywords:
Complete heart blockfentanylpregnancyspinal anaesthesia

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