Combined spinal-epidural anesthesia for cesarean section in a patient with peripartum dilated cardiomyopathy

R. Shnaider, T. Ezri, P. Szmuk, S. Larson, R. D. Warters, J. Katz

Research output: Contribution to journalArticle

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Purpose: To report a case of peripartum dilated cardiomyopathy associated with morbid obesity and possible difficult airway presenting for elective Cesarean section, which was successfully managed with combined spinal-epidural anesthesia. Clinical features: A morbidly obese parturient with a potentially difficult airway, suffering from idiopathic peripartum cardiomyopathy (ejection fraction 20%), was scheduled for an elective Cesarean section. A combined spinal epidural anesthesia was performed and 6 mg of bupivacaine were injected into the subarachnoid space. This was supplemented after 60 min with 25 mg of bupivacaine injected epidurally. The patient’s hemodynamic status was monitored with direct intra-arterial blood pressure and central venous pressure measurements. The patient’s perioperative course was uneventful. Conclusion: In patients suffering from peripartum cardiomyopathy, undergoing Cesarean section, combined spinal-epidural anesthesia may be an acceptable anesthetic alternative.

Original languageEnglish (US)
Pages (from-to)681-683
Number of pages3
JournalCanadian Journal of Anesthesia
Issue number7
StatePublished - Jan 1 2001


ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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