Epidural Anaesthesia For Emergency Cesarean Section In Patient With Takayasu Arteritis – Case Report

Abstract

Background: Takayasu’s arteritis (TA) is a granulomatous disease which is progressive in nature. This disorder is an inflammatory vasculitis which affects mainly aorta and its branches resulting in end-organ dysfunction , stenosis of main blood vessels and also in monitoring of blood pressure during anaesthesia. The advantage of Regional anesthesia over General anesthesia include an attenuation of sympathetic – mediated increase in HR and CO and minimal alteration in  hemodynamics. This case report briefs about the how epidural anaesthesia was successfully employed for cesearen section in a women with chronic untreated Takayasu arteritis. 

Case report:  A 31 year old female who is a known case of untreated Takayasu arteritis with no complications came with active labor pain who was posted for cesarean section.  Local anesthetic was administered in fractioned doses to achieve the slow installation of blockade.  The patient was hemodynamically stable after which she was transferred to intensive care unit during the postoperative period..

Conclusion: Numerous complications may arise in gravidas with TA, necessitating meticulous patient assessment, management of TA-related complications, and anesthetic-surgical planning. Ensuring adequate perfusion is paramount, and neuraxial blocks can be administered safely; thus, patients should be observed in intensive or special care unit for 24 hours to prevent postoperative complications.