Successful Spinal Anaesthesia in a Patient of Takayasu's Arteritis for Emergency Lower Segment Caserian Section

Abstract

Takayasu's arteritis (TA) is a rare, chronic progressive pan-endarteritis involving the aorta and its main branches. Anaesthesia for patients with TA is complicated by their severe uncontrolled hypertension, end- organ dysfunction. We had a 26 year-old, 94 kg woman married since 6 years with G2 P1IUFD1, with 36.5 weeks of amenorrhoea (by date) and known case of Takayasu's Arteritis with non-functioning left kidney and chronic hypertension admitted for safe confinement. Patient was having pain in abdomen when presented to operation theatre for emergency lower segment caesarean section in view of non-progression of labour. A spinal anaesthesia was given to this patient with 23G Quincke's spinal needle. A spinal level of T6 was achieved and patient got delivered successfully. She was hemodynamically stable throughout the procedure. I. Introduction Takayasu described a rare illness characterized by occlusion of the principal arteries arising from the aortic arch. This disease is also referred to by many other names, including pulseless disease, aortic arch syndrome, young female arteritis, idiopathic aortitis, reversed coarctation, and Martorell syndrome. It affects females in over 85% of cases. The major clinical finding is loss of palpable pulses in the upper limbs and neck. The unsuspected ischemia in vital regional vascular beds may be associated with high anesthetic risks for these patients. This case report discusses anaesthetic management in Takayasu's Arteritis with pregnancy.