Lalenoh, Diana Christine and Lalenoh, Hermanus J. and Bisri, Tatang
Anesthesia Management in Cesarean Section with Major Arrhytmia and Morbid Obese.
2nd ANNUAL SYMPOSIUM ON ANESTHESIA COMPLlCATIONS.
Abstract
Background
During pregnancy there is an increased incidence of both benign arrhythmias and
arrhythmias associated with cardiac disease. If the abnormal rhythm causes haemodynamic
i-nst~bility, there is potential for fetal compromise and treatment should be institutes.
Objective
The purpose of this case report is to summarize some strategies for cesarean section patient
with major arrhyrhmia-ventricular premature contractions-with bigemini, trigemini, and
RonT.
Case Report
Here we report a morbid obese female, 27 years old, with aterm gestational age, which is
underwent cesarean section because of breech presentation in labour. Patient is 101 kgs
bodywieght, 150 cm of height, blood pressure is 180/101 mmHg, heart rate is 103 times/
minute, respiration rate 20 times/minute, diagno?e with major arrhythmia. Mter give
binasal oxygen 2 litres/minute and intravenous lidocaine, we performed spinal anesthesia.
During surgery, blood pressure range from 92-138/50-94 mmHg, heart rate from 88-105
times/minute. Mter surgery, patient was transferred to ICD for one day, after that she
transferred to the ward.
Discussion
We care the balance of oxygen demand and consumption, 'with morbid obese condition,we
kept the oxygenation adequate, do not hypoxia and hypercarbia. We choose the spinal
anesthesia techniques with slight anxiolityc after delivery. The mother and and baby
outcome is good.
Conclusions
Correct anesthesia management during cesarean section perioperative with major
arrhythmia is based on an understanding of the mechanism that caused the arrhythmia.
It may not only be lifesaving for the mother but may also play an important role for the
fetus.
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