Anaesthetic management in a parturient with Takayasu arteritis

AbstractWe report the anaesthetic management of a parturient suffering from Takayasu's arteritis scheduled for elective caesarean section. A full term 29-year-old female weighing 50kg, height 152cm, gravida3, para 1 with previous lower segment caesarean section (LSCS) was scheduled for elective LSCS. Patient had suffered a right sided frontoparietal infarct 14years back for which she underwent treatment in the form of medication from some higher centre She was advised tablet aspirin 75mg and prednisolone 40mg once a day. Digital subtraction angiography showed complete occlusion of origin of both subclavian and carotids and reformation of collaterals. Echocardiography revealed mild concentric left ventricular hypertrophy, trivial AR and normal left ventricular systolic function. Caesarean section was planned under regional anaesthesia with monitoring gadgets placed on lower limb. Subarachnoid block (SAB) was administered with 7.5mg hyperbaric bupivacaine along with 25μg fentanyl at lumbar 4–5 interspace, using a 25-G Quincke Babcock needle. Intra-operative period was uneventful with minimal fall in blood pressure which was managed accordingly. Parturient was stable in the postoperative period and was moved to a ward after being monitored for 24h in ICU