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.
Highlights
Takayasu’s arteritis (TA) is a rare inflammatory vascular disease most common in young, Asian women
Anesthetic approaches have varied for parturients with TA, and there are reports in the literature of general anesthesia as well as neuraxial analgesia,[5,6,7,8,9,10,11,12,13,14,15,16] including the use of a combined spinal-epidural (CSE) technique with local anesthetic alone for cesarean section.[17]
We report a successful CSE with opioid-only medication injected into the intrathecal space followed by a combined local anesthetic-opioid epidural infusion
Summary
Takayasu’s arteritis (TA) is a rare inflammatory vascular disease most common in young, Asian women. We report a successful CSE with opioid-only medication injected into the intrathecal space followed by a combined local anesthetic-opioid epidural infusion.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
