Successful Epidural Anesthesia for Cesarean Delivery in a Woman With Fontan Repair

Abstract

based on this study, several points must be considered. Although the correlation (−0.26) was statistically significant, it was a weak negative relationship. Furthermore, the coefficient of determination was 0.068. As such, only 6.8% of the variance in the sevoflurane requirements may be explained by serum progesterone concentration. The data are useful, not so much for clinical management, but because this investigation begins to improve our understanding of the effect of pregnancy on anesthetic requirements. Serum progesterone appears to play a minor role. Comment by Robert Gaiser, MD, MSEd Disclosure: The author declares no conflict of interest. REFERENCES 1. Paech MJ, Scott KL, Clavisi O, et al. A prospective study of awareness and recall associated with general anaesthesia for caesarean section. Int J Obstet Anesth. 2008;17:298-303. 2. Jinks SL, Bravo M, Hayes SC. Volatile anesthetic effects on midbrainelicited locomotion suggest that the locomotor network in the ventral spinal cord is the primary site for immobility. Anesthesiology. 2008;108: 1016-1024. 3. Ueyama H, Hagihira S, Takashina M, et al. Pregnancy does not enhance volatile anesthetic sensitivity on the brain: an electroencephalographic analysis study.

Management of cesarean section in a patient with Fontan circulation: a case report of dramatic reduction of maternal oxygen consumption after delivery

“…During pregnancy, dynamic physiological changes occur, including an increase in cardiac output, oxygen consumption, and intravascular volume, making both pregnancy and delivery challenging for these patients [6]. Previous reports have described the perioperative management of cesarean section in Fontan-palliated parturients [7][8][9][10]. However, hemodynamic monitoring of central venous oxygen saturation (ScvO 2 ) and oxygen consumption (VO 2 ) during this procedure has never been reported.…”