1
|
Dan K, Takahashi K, Lefor AK. Measuring and maintaining organ perfusion in a patient with Takayasu's arteritis undergoing cardiac surgery. Anaesth Rep 2023; 11:e12236. [PMID: 37408768 PMCID: PMC10318576 DOI: 10.1002/anr3.12236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2023] [Indexed: 07/07/2023] Open
Abstract
Takayasu's arteritis is a rare vasculitis affecting the aorta and its branches. Disease progression can result in arterial stenosis and subsequent organ dysfunction. Estimating organ perfusion by measuring the peripheral blood pressure can be challenging because it may be altered by arterial stenosis. We report the case of a 61-year-old woman with Takayasu's arteritis with aortic and mitral regurgitation who presented for aortic valve replacement and mitral valvuloplasty. Peripheral arterial pressure was considered a less reliable surrogate for organ perfusion because the patient had diminished blood flow in both the lower and upper extremities. In addition to the bilateral radial arterial pressure, the blood pressure in the ascending aorta was monitored to estimate the patient's organ perfusion pressure during cardiopulmonary bypass. The initial target blood pressure was determined based on the pre-operative baseline and modified by measurement of the aortic pressure. Cerebral oximetry using near-infrared spectroscopy and mixed venous saturation was monitored to estimate oxygen supply-demand balance, which helped evaluate cerebral perfusion and determine the transfusion threshold. The entire procedure was uneventful, and no organ dysfunction was observed postoperatively.
Collapse
Affiliation(s)
- K. Dan
- Department of AnaesthesiaTokyo Bay Urayasu Ichikawa Medical CenterChibaJapan
| | - K. Takahashi
- Department of AnaesthesiaJichi Medical University Saitama Medical CenterSaitamaJapan
| | - A. K. Lefor
- Department of SurgeryJichi Medical UniversityTochigiJapan
| |
Collapse
|
2
|
A comprehensive guide for managing the reproductive health of patients with vasculitis. Nat Rev Rheumatol 2022; 18:711-723. [PMID: 36192559 PMCID: PMC9529165 DOI: 10.1038/s41584-022-00842-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 11/08/2022]
Abstract
Vasculitides and their therapies affect all areas of the reproductive life cycle. The ACR, EULAR and the Drugs and Lactation database offer guidance on the management of the reproductive health of patients with rheumatic diseases; however, these guidelines do not address patients with vasculitis specifically. This Review discusses the guidance from multiple expert panels and how these recommendations might apply to men and women with vasculitis, including the safety of contraception, use of assisted reproductive technology, preservation of fertility during cyclophosphamide therapy, disease management in pregnancy and the use of medications compatible with pregnancy and lactation. These discussions are augmented by the existing literature on vasculitis in pregnancy to enable physicians to provide comprehensive, precise and high quality care to patients with vasculitis. The contents of this Review, in conjunction with educational tools, serve to empower patients and physicians to participate in shared decision-making regarding pregnancy prevention, planning and management. This Review discusses how best to manage the reproductive health of patients with vasculitis, including the safety of contraception, the use of assisted reproductive technology, preservation of fertility during therapy, disease management in pregnancy and the use of medications compatible with pregnancy and lactation. Rheumatologists have the opportunity to initiate discussions with patients with vasculitis regarding family planning to make proactive decisions leading to improved pregnancy planning, management and outcomes. Birth control options and infertility interventions for women with vasculitis depend on their risk of thrombosis, serological profile and comorbid conditions. The majority of pregnancies in patients with vasculitis can be successful with the use of advanced family planning, medications compatible with pregnancy and lactation, and multidisciplinary collaboration among specialists. Vasculitis exacerbations and pregnancy complications can present with similar and overlapping clinical manifestations. Multiple expert panels provide guidelines and risk stratification regarding medication use in pregnancy and breastfeeding that can be applied to patients with vasculitis.
Collapse
|
3
|
Takaishi K, Takata M, Aoki R, Fujiwara SJL, Kawahito S, Kitahata H. Total Intravenous Anesthesia Using Remimazolam and Continuous Cardiac Output Monitoring for Dental Anesthesia in a Patient With Takayasu’s Arteritis: A Case Report. A A Pract 2022; 16:e01599. [DOI: 10.1213/xaa.0000000000001599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
4
|
Varghese K, Swain A, Sahu S, Mohanty P, Shukla R. Combined Spinal-Epidural Anaesthesia for Caesarean Delivery in Takayasu's Arteritis: A Viable Alternative. Cureus 2021; 13:e12459. [PMID: 33552777 PMCID: PMC7854924 DOI: 10.7759/cureus.12459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Takayasu's arteritis (TA), also known as “pulseless disease”, is a nonspecific inflammatory arteritis of large and medium caliber arteries of unknown aetiology with a predilection for young women of childbearing age. Although the evolution of the disease is not affected during pregnancy, it can result in uncontrolled hypertension, multiple organ dysfunction, and stenosis that hinder regional blood flow. Associated pregnancy, therefore, poses an increased risk to the mother and foetus due to the many cardiovascular complications that can occur in the course of the disease, making anaesthesia for caesarean delivery especially challenging to the anaesthesiologist. We report the successful anaesthetic management of a case of TA undergoing caesarean section in view of a previous caesarean delivery. We also engage in a brief review of the related literature.
Collapse
Affiliation(s)
| | - Amlan Swain
- Anaesthesiology, Tata Main Hospital, Jamshedpur, IND
| | - Seelora Sahu
- Anaesthesiology, Tata Main Hospital, Jamshedpur, IND
| | | | - Rajiv Shukla
- Anaesthesiology, Tata Main Hospital, Jamshedpur, IND
| |
Collapse
|
5
|
Kikuchi Y, Kuroda M, Saito S. Anesthetic Management of Emergency Cesarean Delivery Followed Immediately by Thoracic Endovascular Aortic Repair for a Peripartum Dissecting Aorta Aneurysm With Impending Rupture (Stanford Type B Dissection) in a Pregnant Patient With Takayasu's Arteritis. J Cardiothorac Vasc Anesth 2020; 34:1897-1901. [PMID: 31937478 DOI: 10.1053/j.jvca.2019.11.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/20/2019] [Accepted: 11/25/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Yuki Kikuchi
- Department of Anesthesia, Saiseikai Utsunomiya Hospital, Tochigi, Japan.
| | - Masataka Kuroda
- Department of Anesthesia, Saiseikai Utsunomiya Hospital, Tochigi, Japan
| | - Shigeru Saito
- Department of Anesthesiology, Gunma University Graduate School of Medicine, Maebashi, Japan
| |
Collapse
|
6
|
Takayasu's Arteritis in Pregnancy: A Rare Case Report from a Tertiary Care Infirmary in India. Case Rep Obstet Gynecol 2017; 2017:2403451. [PMID: 28265476 PMCID: PMC5318617 DOI: 10.1155/2017/2403451] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/11/2017] [Accepted: 01/15/2017] [Indexed: 12/03/2022] Open
Abstract
Background. Takayasu's arteritis (TA) is a rare, chronic, inflammatory, progressive, idiopathic arteriopathy, afflicting young women of reproductive age group, causing narrowing, occlusion, and aneurysms of systemic and pulmonary arteries, especially the aorta and its branches. During pregnancy, such patients warrant special attention. An interdisciplinary collaboration of obstetricians, cardiologists, and neurologists is necessary to improve maternal and fetal prognosis. Here a case is reported where a patient with diagnosis of TA, complicated by neurological sequelae, successfully fought the vagaries of the condition twice to deliver uneventfully. Case. 25-year-old G2P1L1 presented at 34 weeks of gestation, with chronic hypertension, with TA, with epilepsy, and with late-onset severe IUGR. Following a multidisciplinary approach, she delivered an alive born low birth weight baby (following induction). Her postpartum course remained uneventful. Conclusion. Pregnancy with TA poses a stringent challenge to an obstetrician. Despite advancements in cardiovascular management and advent of new-fangled drugs, the optimal management for pregnant patients with this disease still remains elusive.
Collapse
|
7
|
Clifford SP, Mick PB, Derhake BM. Combined Spinal-Epidural for Vaginal Delivery in a Parturient With Takayasu's Arteritis. J Investig Med High Impact Case Rep 2016; 4:2324709616683725. [PMID: 28210635 PMCID: PMC5298530 DOI: 10.1177/2324709616683725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 11/01/2016] [Accepted: 11/08/2016] [Indexed: 12/05/2022] Open
Abstract
Takayasu's arteritis is a rare, progressive panendarteritis involving all layers of the arterial wall. This disease includes variable involvement of the aorta and its major branches. The most common complication with this condition is severe, uncontrolled hypertension, often leading to end organ dysfunction. We describe the management of a 27-year-old woman diagnosed with Takayasu's arteritis that presented in labor with intense pain and underwent a combined spinal-epidural for anesthetic management. Per literature review, a combined spinal-epidural technique for planned vaginal delivery has not been described for a laboring Takayasu patient. Our technique, utilizing intrathecal opioids and a low-dose local anesthetic-opioid epidural infusion, provided adequate analgesia while maintaining hemodynamic stability throughout labor augmentation and successful vaginal delivery.
Collapse
|
8
|
Yoshida M, Yamamoto T, Shiiba S, Harano N, Sago T, Nunomaki M, Watanabe S. Anesthetic Management of a Patient With Takayasu Arteritis. Anesth Prog 2016; 63:31-3. [PMID: 26866409 DOI: 10.2344/14-00006r1.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Takayasu arteritis is a rare chronic progressive panendarteritis involving the aorta and its main branches. Anesthesia in patients with this disease can be complicated by severe uncontrolled hypertension, end-organ dysfunction, and stenosis of major blood vessels. In this case, general anesthesia was induced with sevoflurane and remifentanil without complications. To prevent intraoperative complications, we conducted intubation with a rigid video laryngoscope with careful consideration of the concentrations of analgesics and sedatives used. This case demonstrates the importance of anesthetic techniques for maintaining adequate tissue perfusion without hemodynamic changes in the anesthetic management of patients with Takayasu arteritis.
Collapse
Affiliation(s)
- Mitsuhiro Yoshida
- Division of Dental Anesthesiology, Department of Control of Physical Function, Kyushu Dental University, Kitakyushu, Fukuoka, Japan, and
| | - Toru Yamamoto
- Department of Dental Anesthesiology, School of Dental Medicine, Tsurumi University, Yokohama, Kanagawa, Japan
| | - Shunji Shiiba
- Division of Dental Anesthesiology, Department of Control of Physical Function, Kyushu Dental University, Kitakyushu, Fukuoka, Japan, and
| | - Nozomu Harano
- Division of Dental Anesthesiology, Department of Control of Physical Function, Kyushu Dental University, Kitakyushu, Fukuoka, Japan, and
| | - Teppei Sago
- Division of Dental Anesthesiology, Department of Control of Physical Function, Kyushu Dental University, Kitakyushu, Fukuoka, Japan, and
| | - Masahito Nunomaki
- Division of Dental Anesthesiology, Department of Control of Physical Function, Kyushu Dental University, Kitakyushu, Fukuoka, Japan, and
| | - Seiji Watanabe
- Division of Dental Anesthesiology, Department of Control of Physical Function, Kyushu Dental University, Kitakyushu, Fukuoka, Japan, and
| |
Collapse
|
9
|
Tiwari AK, Tomar GS, Chadha M, Kapoor MC. Takayasu's arteritis: Anesthetic significance and management of a patient for cesarean section using the epidural volume extension technique. Anesth Essays Res 2015; 5:98-101. [PMID: 25885310 PMCID: PMC4173377 DOI: 10.4103/0259-1162.84184] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Takayasu's arteritis (TA) is a rare, chronic progressive pan-endarteritis involving the aorta and its main branches. Anesthesia for patients with TA is complicated by severe uncontrolled hypertension, end-organ dysfunction, stenosis of major blood vessels, and difficulties in monitoring arterial blood pressure. We present the successful anesthetic management of a 23-year-old woman having TA with bilateral subclavian and renal artery stenosis posted for emergency cesarean section by using the epidural volume extension technique, which offers the combined advantage of both spinal and epidural anesthesia and, at the same time, also avoids the need of sophisticated neurological monitors like EEG and transcranial Doppler.
Collapse
Affiliation(s)
| | - Gaurav Singh Tomar
- Department of Anesthesia, Sushruta Trauma Centre, Civil Lines, New Delhi, India
| | - Madhur Chadha
- Department of Anesthesia, St. Stephens Hospital, Tees Hazari, India
| | - Mukul C Kapoor
- Department of Cardiothoracic Anesthesia, Command Hospital (CC), Lucknow, Uttar Pradesh, India
| |
Collapse
|
10
|
Lee EH, Choi E, Ahn W. Application of cerebral oximetry for a parturient with Takayasu's arteritis undergoing cesarean section -a case report-. Korean J Anesthesiol 2013; 65:158-62. [PMID: 24024000 PMCID: PMC3766783 DOI: 10.4097/kjae.2013.65.2.158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Revised: 09/10/2012] [Accepted: 09/20/2012] [Indexed: 11/16/2022] Open
Abstract
Takayasu's arteritis (TA) is a chronic inflammatory disease involving the aorta. Because TA sometimes involves cerebral arteries, anesthetic debates focus on cerebral monitoring. There is limited evidence as to which cerebral monitoring method is most adequate. Furthermore, there is insufficient evidence to determine which anesthetic technique is better for TA parturients. We experienced the case of a TA parturient who developed transient cerebral ischemia during cesarean section. The patient's TA involved her cerebral arteries, and her regional cerebral oxygen saturation (rSO2) was lower in the left side than in the right side. She complained of speech impairment, tinnitus, and stiffness of the posterior neck when the rSO2 levels dropped. The FloTrac/Vigileo™ system did not correlate with clinical symptoms, but the cerebral oximeter displayed the low oxygen saturation. We recommend the cerebral oximetry for cerebral monitoring in TA parturients who undergo cesarean sections, especially in hemodynamically unstable patients under regional anesthesia or unconscious patients under general anesthesia.
Collapse
Affiliation(s)
- Eun Hye Lee
- Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea
| | | | | |
Collapse
|
11
|
Gautam S, Srivastava VK, Kumar S, Wahal R. Successful low-dose spinal anaesthesia for lower segment caesarean section in a patient with Takayasu arteritis. BMJ Case Rep 2013; 2013:bcr2013010107. [PMID: 23709154 PMCID: PMC3670024 DOI: 10.1136/bcr-2013-010107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Takayasu arteritis is a rare, chronic idiopathic, occlusive inflammation of the aorta and its major branches. It is a rare form of non-specific obliterative panarteritis of unknown aetiology. Anaesthesia for the patient with Takayasu arteritis is complicated by severe uncontrolled hypertension leading to end organ dysfunction, stenosis of major blood vessel affecting regional circulation and difficulties in the monitoring of arterial blood pressure. We report a 26-year-old woman multigravida who was diagnosed with Takayasu arteritis who underwent an emergency caesarean section under spinal anaesthesia. In this case study, the whole course of anaesthesia and operation was uneventful due to thorough systemic evaluation and planned anaesthetic management.
Collapse
Affiliation(s)
- Shefali Gautam
- Department of Anaesthesiology, King George's Medical University, Lucknow, Uttar Pradesh, India.
| | | | | | | |
Collapse
|
12
|
Chaudhuri S, Narasimha P, Joseph T. Utility of intra-operative ultrasound in choosing the appropriate site for blood pressure monitoring in Takayasu′s arteritis. Indian J Anaesth 2013; 57:66-8. [PMID: 23716770 PMCID: PMC3658340 DOI: 10.4103/0019-5049.108571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Takayasu's arteritis (TA) is rare, chronic progressive, pan-endarteritis involving the aorta and its main branches, with a specific predilection for young Asian women. Anaesthesia for TA patients is complicated by their severe uncontrolled hypertension, extreme arterial blood pressure differentials, aortic regurgitation (AR), end-organ dysfunction, stenosis/aneurysms of major blood vessels and difficulties encountered in monitoring arterial blood pressure. We present the usefulness of ultrasound during anaesthetic management of a 35-year-old woman posted for emergency caesarean section due to intra-uterine growth retardation, foetal tachycardia in active labour, who was already diagnosed to have TA along with moderate AR and uncontrolled hypertension, using epidural technique. The use of intra-operative doppler helped resolve the initial dilemma about the diagnosis and treatment of the differential blood pressure between the affected and the normal upper limb in the absence of prior arteriogram.
Collapse
|
13
|
Takayasu Arteritis Complicating Pregnancy in Adolescence. Ann Vasc Surg 2012; 26:858.e7-10. [DOI: 10.1016/j.avsg.2011.11.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Revised: 11/04/2011] [Accepted: 11/15/2011] [Indexed: 11/19/2022]
|
14
|
Gatto M, Iaccarino L, Canova M, Zen M, Nalotto L, Ramonda R, Punzi L, Doria A. Pregnancy and vasculitis: A systematic review of the literature. Autoimmun Rev 2012; 11:A447-59. [DOI: 10.1016/j.autrev.2011.11.019] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
15
|
|
16
|
Leal PDC, Silveira FFM, Sadatsune EJ, Clivatti J, Yamashita AM. Takayasus's arteritis in pregnancy. Case report and literature review. Rev Bras Anestesiol 2011; 61:479-85. [PMID: 21724011 DOI: 10.1016/s0034-7094(11)70056-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2010] [Accepted: 01/17/2011] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Takayasus's Arteritis (TA) is a chronic, inflammatory, progressive, idiopathic disease that causes narrowing, occlusion, and aneurysms of systemic and pulmonary arteries affecting especially the aorta and its branches. During pregnancy, one should pay special attention to these patients. The objective of this report was to present the peripartum anesthetic care of a patient with TA and a review of the literature. CASE REPORT This is a 31-year old gravida who underwent exchange of the aortic arch and placement of a metallic aortic valve for TA four years ago. She had no complications during pregnancy, and she was admitted at 34 weeks of pregnancy for anticoagulation management. Elective cesarean section was performed at 39 weeks with continuous epidural anesthesia. Fractionated doses of local anesthetic were administered to guarantee slow installation of the blockade. The patient remained hemodynamically stable and was transferred to the ICU in the postoperative period. CONCLUSIONS Several complications can affect gravidas with TA. Careful patient evaluation, treatment of TA complications, and anestheticsurgical planning are fundamental. Maintenance of perfusion is the main concern in these patients, and neuraxial blocks may be used without harming the mother and fetus. In patients with compensated TA complications, monitoring does not differ from that routinely used in cesarean sections. Continuous epidural anesthesia with slow installation maintains hemodynamic stability and allows monitoring cerebral perfusion through the level of consciousness. To avoid postoperative hypoperfusion or hypertensive complications patients should be monitored in an intensive or semi-intensive care unit for 24 hours.
Collapse
|
17
|
|
18
|
Ioscovich A, Gislason R, Fadeev A, Grisaru-Granovsky S, Halpern S. Peripartum anesthetic management of patients with Takayasu’s arteritis: case series and review. Int J Obstet Anesth 2008; 17:358-64. [DOI: 10.1016/j.ijoa.2007.12.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2007] [Accepted: 12/01/2007] [Indexed: 10/21/2022]
|
19
|
McCarthy EM, Cunnane G. Basic clinical examination skills may save lives. Rheumatol Int 2008; 29:217-8. [DOI: 10.1007/s00296-008-0657-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2008] [Accepted: 07/25/2008] [Indexed: 11/29/2022]
|
20
|
Kim YH, Lim SH, Lee JI, Lee SE, Kim YH, Lee JH, Lee KM, Cheong SH, Choe YK, Kim YJ, Shin CM. Left subclavian artery stenosis found by the interarm blood pressure difference during combined spinal-epidural anesthesia of patient with peripheral vascular disease - A case report -. Korean J Anesthesiol 2008. [DOI: 10.4097/kjae.2008.55.2.229] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Yong Han Kim
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Se Hun Lim
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Jae In Lee
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Sang Eun Lee
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Young Hwan Kim
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Jeong Han Lee
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Kun Moo Lee
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Soon Ho Cheong
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Young Kyun Choe
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Young Jae Kim
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Chee Mahn Shin
- Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| |
Collapse
|
21
|
Abstract
Until recently, the prognosis associated with many forms of systemic vasculitis was quite grim. Advances in this field have allowed us to begin to focus on issues related to quality of life such as fertility, conception, and pregnancy among women with vasculitis. Because the systemic vasculitides are rare diagnoses, many important questions remain unanswered. Overall, it seems that women who have inactive vasculitis may not be subject to unusual complications during pregnancy, but our understanding of the interaction between pregnancy and specific forms of vasculitis continues to evolve.
Collapse
Affiliation(s)
- Philip Seo
- The Johns Hopkins University, Division of Rheumatology, Baltimore, MD 21224, USA.
| |
Collapse
|
22
|
Arthroscopic knee surgery in a patient with Takayasu's arteritis: the role of intra-articular local anaesthesia. Eur J Anaesthesiol 2004. [DOI: 10.1097/00003643-200403000-00018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
23
|
Grewal K, Samsoon G. Combined spinal-epidural anaesthesia for caesarean section in a patient with Takayasu’s disease. Int J Obstet Anesth 2003; 12:234-5. [PMID: 15321485 DOI: 10.1016/s0959-289x(03)00039-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
24
|
Stamer UM, Stüber F. Anaesthesia for non-scheduled caesarean delivery. Curr Opin Anaesthesiol 2002; 15:293-8. [PMID: 17019215 DOI: 10.1097/00001503-200206000-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In many countries there has been an increase in the number of women who deliver by caesarean section. This article reviews anaesthetic management of non-scheduled caesarean section. The choice of anaesthetic technique (regional anaesthesia versus general anaesthesia) is discussed and highlighted particularly from the viewpoint of urgency of operative delivery. A multidisciplinary approach is mandatory especially in emergency cases to prevent morbidity and mortality in mothers and neonates.
Collapse
Affiliation(s)
- Ulrike M Stamer
- Department of Anaesthesiology and Intensive Care Medicine, University of Bonn, Bonn, Germany.
| | | |
Collapse
|