Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2005
Case ReportsGeneral anesthesia with remifentanil for Cesarean section in a patient with HELLP syndrome.
HELLP syndrome is a severe complication of pre-eclampsia characterised by hemolysis, elevated liver enzymes and a low platelet count. It is associated with an increased risk of adverse outcome for both the mother and the fetus. Patients with HELLP syndrome are also at greater risk of pulmonary edema, adult respiratory distress syndrome, abruptio placentae, intracerebral hemorrhage, eclamptic convulsions, disseminated intravascular coagulation, ruptured liver hematomas and acute renal failure. ⋯ The anesthetic technique is critical for these patients with a high risk of uncontrollable hypertension, bleeding and multiple organ failure. Remifentanil is increasingly used as a very short analgesic agent providing cardiovascular stability in high-risk patients. We report the management of a patient presenting in labor with HELLP syndrome, and describe the successful use of remifentanil as part of the anesthetic technique for her subsequent Cesarean section.
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Acta Anaesthesiol Scand · Mar 2005
Editorial Historical ArticleFrom crystal ball towards cognitive anaesthesiology.