Central Neuroaxial Block Anesthesia: A Safe Choice for Caesarean Section in Patients with Mitral Stenosis

Abstract

Background: Mitral stenosis heart valve abnormalities in pregnant women is a complication of pregnancy that is quite common, accompanying rheumatic heart disease, endocarditis, and congenital abnormalities. In pregnancy, there have been changes in the cardiorespiratory system caused by increased cardiac output, which the presence of mitral valve stenosis can then exacerbate. Anesthesia management plays an essential role in the safety of the mother and baby during and after surgery. The choice of technique and anesthesia management depends on the abnormality’s severity. Case: We report the successful management of anesthesia with pure central neuraxial epidural block and combined spinal epidural (CSE) in two cases of a cesarean section of 3rd-trimester pregnant women with mitral stenosis and class II functional heart failure caused by rheumatic heart disease. Conclusion: Central neuraxial block epidural anesthesia and combined spinal epidural (CSE) anesthesia are safe anesthesia techniques for both mother and baby because they can maintain hemodynamic stability.