Spinal anaesthesia in a patient with Takayasu's disease

Abstract

We report the successful anaesthetic management of therapeutic abortion under spinal anaesthesia in a 32-yr-old woman with Takayasu's disease. The pathology and pathophysiology of this syndrome and their impact on anaesthesia are discussed.

Anaesthetic management of a pregnant patient with Takayasu’s disease undergoing abdominal aortic aneurysm repair

“…14,15 Moreover, hypertension, congestive heart failure and possible cerebral haemorrhage may worsen in pregnant patients with Takayasu's arteritis. 4 The presence of all these findings in our patient made surgery necessary during pregnancy.…”

“…3 A number of case reports describe the anaesthetic management of pregnant women with Takayasu's arteritis undergoing caesarean delivery. [4][5][6] Recently, the surgical management of descending thoracic aortic aneurysm during a twin pregnancy has been reported. 7 However, the anaesthetic management of a pregnant patient undergoing repair of abdominal aortic aneurysm has yet to be described.…”

Epidural anaesthesia for Caesarean section in a patient with severe Takayasu's disease

“…Although spinal anaesthesia for delivery of patients with Takayasu's disease has not been reported (except for therapeutic termination of pregnancy in a patient with mild Takayasu's disease) 18 the use of epidural anaesthesia 19 " 21 is becoming more accepted as hypotension is not commonly a problem and cerebral function can be assessed easily in an awake patient. Epidurals also allow parents to participate in the delivery of their baby and can provide good pain relief after operation, reducing the risk of further increases in arterial pressure.…”

Successful spinal anaesthesia for caesarean section in an African patient with Takayasu�s arteritis

“…TA usually affects aorta and its main branches commonly: carotid, subclavian and renal arteries [1-10]. TA affects more women than men with a ratio ranging from 4:1to 8:1[2-4, 10, 11]. The peak incidence is in the 2 nd -3 rd decades [5].…”

“…Clinical symptoms depend on the distribution of the involved vasculature and ischemic disturbance of the organs affected. This may result in claudication, ischemic pain and fatigue of the limbs, and carotid arteries may give headache, vertigo, syncope, convulsions, transient hemiplegia, aphasia, and visual disturbance; renal artery involvement may cause hypertension and some patients may progress to aortic insufficiency and congestive heart failure [1, 2, 5, 9]. Physical findings depends on the affected artery and include high blood pressure and reduction or loss of palpable pulses in the neck and limbs [7, 9].…”