Anesthetic management of a patient presenting with eclampsia

Abstract

Eclampsia is one of the most common emergencies encountered by anesthesiologists which involve a safe journey of two lives. The definition, etiology, pathophysiology, treatment guidelines along with a special reference to management of labour pain and caesarean section are discussed. Eclampsia is commonly faced challenging case in our day to day anaesthesia practice,but less is discussed in our anaesthesia text books. Lot of controversies with regard to fluid management and monitoring still remain unanswered

Case Report: Intensive Care Management of Preeclampsia and HELLP Syndrome

“…This mechanism then causes the formation of thrombus in the microvascular which inhibits perfusion to the tissue resulting in organ failure, in addition to the consumption of many coagulation factors resulting in a deficiency of the coagulation and platelet factors leading in bleeding. (Sahin, 2014) Figure1 Pathophysiology of preeclampsia Cited from: Parthasarathy (Parthasarathy, 2013) The main goal of the management of preeclampsia is to prevent seizures and reduce maternal blood pressure below 160/110 mmHg. (Kelsey, 2015) Management of preeclampsia, eclampsia, and HELLP syndrome consists of:…”

Management of atypical eclampsia with intraventricular hemorrhage: A rare experience and learning!

“…Anesthetic management in unconscious eclamptic patients may present several dilemmas including rapid sequence induction while blocking the stress responses to laryngoscopy, drug interaction between magnesium sulfate with muscle relaxant, regarding use of internal jugular cannulation with brain edema and the risk of laryngeal edema presenting as difficult airway. [ 7 8 ] Until now, only two cases of successful management in eclamptic patient with intracerebral hemorrhage by craniotomy with cesarean section had been reported. [ 8 9 ] The importance of early clinical and radiological assessment of the central nervous system in eclampsia patient with a sudden decrease in conscious level has also been emphasized.…”

Management of Preeclampsia in Perioperative Conditions

“…Among the local anesthetics, a low concentration of bupivacaine, 0.125%, with 2 μg/ml of fentanyl as an initial bolus provides excellent analgesia with minimal motor block. Lesser the motor block, greater the benefits with regard to fetal head rotation [48]. In addition the presence of a functioning epidural catheter enables the use of the epidural catheter for titrating local anaesthetic to ensure surgical anaesthesia if delivery turns to cesarean section [49].…”