Cesarean section and primary pulmonary hypertension: the role of intravenous dexmedetomidine.

Abstract:

:Primary pulmonary hypertension is a fatal disease that frequently becomes evident in pregnancy. The management of pregnant women with primary pulmonary hypertension poses a number of difficult problems, especially where regional anesthesia is considered to be contraindicated. A 30-year-old woman who developed primary pulmonary hypertension at 23 weeks of pregnancy was transferred to our hospital. Systolic pulmonary artery pressure and plasma brain natriuretic peptide levels were markedly elevated. Nitric oxide inhalation and prostacyclin prevented the progression of cardiac failure and reduced both plasma brain natriuretic peptide and pulmonary artery pressure. Cesarean section was performed at 32 weeks under general anesthesia. A combination of nitric oxide, prostacyclin, nitroglycerin, and dobutamine were administered during surgery. Intravenous dexmedetomidine was specifically used during emergence and recovery from anesthesia. This provided effective pain relief and hemodynamic stability. Throughout the clinical course, brain natriuretic peptide levels was monitored and used as an indicator of cardiac failure.

journal_name

Int J Obstet Anesth

authors

Toyama H,Wagatsuma T,Ejima Y,Matsubara M,Kurosawa S

doi

10.1016/j.ijoa.2008.08.001

subject

Has Abstract

pub_date

2009-07-01 00:00:00

pages

262-7

issue

3

eissn

0959-289X

issn

1532-3374

pii

S0959-289X(08)00139-8

journal_volume

18

pub_type

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