PMID- 20229760
OWN - NLM
STAT- MEDLINE
DCOM- 20100429
LR  - 20100316
IS  - 0021-4892 (Print)
IS  - 0021-4892 (Linking)
VI  - 59
IP  - 3
DP  - 2010 Mar
TI  - [Paracervical block for dilatation and curettage in a parturient with 
      Eisenmenger's syndrome].
PG  - 379-82
AB  - Eisenmenger's syndrome is defined as the process in which a left-to-right shunt 
      due to an atrial (ASD) or ventricular septal defect (VSD) in the heart causes 
      increased pulmonary blood flow, leading to pulmonary hypertension, which in turn, 
      ultimately results in increased pressure in the right side of the heart and 
      reversal of the shunt to right-to-left. Therefore, anesthetic management of 
      Eisenmenger's syndrome is often difficult. We described a case of paracervical 
      block for dilatation and curettage in a parturient with Eisenmenger's syndrome in 
      this report. A 29-year-old woman with Eisenmenger's syndrome due to ASD became 
      pregnant. She had dyspnea, cyanosis, and clubbed fingers. Her activity of daily 
      life was in a wheel chair, and she was evaluated as New York Heart Association 
      (NYHA) class IV. Her oxygen saturation by pulse oxymeter (Sp(O2)) showed 78-82% 
      in room air. Dilatation and curettage was scheduled in the sixth week of her 
      pregnancy. We performed paracervical block in the direction of 4 and 8 o'clock 
      using 1% lidocaine 12 ml under 6 l x (min(-1) oxygen inhalation through a face 
      mask. Seven minutes after the beginning of the operation, Sp(O2) temporarily 
      decreased to 77% due to abdominal pain by surgical procedures. The operation was 
      finished within 8 minutes. She had no adverse events postoperatively. The 
      anesthetic goal for Eisenmenger's syndrome is to avoid hemodynamic changes that 
      can worsen hypoxemia through an increase in right-to-left shunt. Paracervical 
      block is safe and effective conduction anesthesia for dilatation and curettage in 
      a parturient with Eisenmenger's syndrome.
FAU - Tsutsumi, Yusuke
AU  - Tsutsumi Y
AD  - Department of Anesthesiology, Teikyo University School of Medicine, Tokyo 
      173-8606.
FAU - Mizuno, Ju
AU  - Mizuno J
FAU - Takada, Shinji
AU  - Takada S
FAU - Morita, Shigeho
AU  - Morita S
LA  - jpn
PT  - Case Reports
PT  - English Abstract
PT  - Journal Article
PL  - Japan
TA  - Masui
JT  - Masui. The Japanese journal of anesthesiology
JID - 0413707
SB  - IM
MH  - *Abortion, Therapeutic
MH  - Adult
MH  - *Anesthesia, Obstetrical
MH  - *Dilatation and Curettage
MH  - *Eisenmenger Complex
MH  - Female
MH  - Humans
MH  - Pregnancy
MH  - *Pregnancy Complications
EDAT- 2010/03/17 06:00
MHDA- 2010/04/30 06:00
CRDT- 2010/03/17 06:00
PHST- 2010/03/17 06:00 [entrez]
PHST- 2010/03/17 06:00 [pubmed]
PHST- 2010/04/30 06:00 [medline]
PST - ppublish
SO  - Masui. 2010 Mar;59(3):379-82.