Anesthesia for elective cesarean section in a patient with congenital acyanotic heart disease

Abstract

We report a case of a pregnant lady with a ventricular septal defect (VSD) of 6 mm size and moderate pregnancy induced hypertension (PAH), with 34 weeks gestation, admitted to our hospital for delivery. She was prepared for Cesarean section under epidural anesthesia. Due to failure of epidural technique, we had to carry out the procedure under spinal anesthesia using 1.5 ml of 0.5% inj. bupivacaine heavy with 25 μg fentanyl. Ampicillin and gentamicin were administered for prophylaxis against bacterial endocarditis. Hypotension was treated with bolus doses of injection phenylephrine 100 μg along with titrated infusion of intravenous Ringer's lactate solution. Patient was monitored in PACU for 6 hour and then shifted to HDU. The recovery was satisfactory and postoperative stay was uneventful.