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Anaesthesia for Caesarean section in Takayasu's disease
1Department of Anaesthesia, Dalhousie University, Saint John Regional Hospital, Canada.
Purpose:
We present a case of Takayasu's Disease (Occlusive Thromboaortopathy-OTAP) in which general anaesthesia was used for Caesarean section with processed encephalographic monitoring to detect cerebral ischaemia.
Clinical Features:
The patient was a 33-year-old woman in whom OTAP had been the cause of cerebrovascular events. She had the typical pulseless upper body of OTAP and had documented severe bilateral carotid artery stenoses. Regional anaesthesia had failed in the past and she demanded general anaesthesia for Caesarean section. Processed electroencephalography was used to assist in monitoring for signs of cerebral ischaemia and the surgery was uncomplicated.
Conclusion:
The use of processed electroencephalographic monitoring allows some assessment of cerebral haemodynamics during general anaesthesia in patients who refuse regional techniques.