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Case Reports
Anaesthetic management of a parturient with the postural orthostatic tachycardia syndrome: a case report.
- W L Corbett, C M Reiter, J R Schultz, R J Kanter, and A S Habib.
- Department of Anaesthesiology, Box 3094, Duke University Medical Center, Durham, NC 27710, USA.
- Br J Anaesth. 2006 Aug 1;97(2):196-9.
AbstractPostural orthostatic tachycardia syndrome encompasses a group of disorders characterized by orthostatic intolerance. We describe the anaesthetic management of analgesia for labour and of Caesarean section in a parturient suffering from this disorder. Worsening of her symptoms during pregnancy was managed with an increase in the dose of beta-blockers taken by the patient. Epidural analgesia was instigated early to attenuate the stress of labour and avoid consequent triggering of a tachycardic response. Slow titration of epidural analgesia and anaesthesia after an adequate fluid preload was undertaken to minimize hypotension and subsequent tachycardia. Neuraxial opioid, combined with non-steroidal anti-inflammatory drugs and bilateral iliohypogastric and ilioinguinal nerve blocks were used to optimize postoperative analgesia.
This article appears in the collection: Anaesthesia and POTS (Postural orthostatic tachycardia syndrome).
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