Abstract
Ultrasound-guided transversus abdominis plane block is an extremely attractive technique ensuring adequate perioperative analgesia. The use of ultrasound has enhanced the accuracy of local anaesthetic deposition in the plane between internal oblique and transversus abdominis, thereby blocking the spinal nerves more effectively and hence enhancing the efficacy of analgesia. Pregnancy is associated with higher frequency of arrhythmias in Wolff-Parkinson-White syndrome and poor perioperative pain management may contribute to life threatening arrhythmias. We report a case of Wolff-Parkinson-White syndrome posted for elective caesarean section, managed successfully under regional anesthesia with transverses abdominis plane block. The block and catheter were deposited under ultrasound guidance with continuous infusion of 0.2% of ropivacaine was used for postoperative pain relief. Dexmetedomidine was also used as intravenous adjunct at titrated dose of 0.4-0.6 mics/kg/min to attenuate maternal hormonal and hemodynamics during surgery.
Highlights
A PEER REVIEWED JOURNALRupesh Kumar Yadav, Anuj Jung Rayamajhi, Prajjwal Raj Bhattarai, Subash Chandra Paudel
White (WPW) syndrome accounts for the majority of supraventricular tachycardia (SVT) during pregnancy; with incidence of 1.2 per 1000 people.[1]
Corresponding Author Rupesh Kumar Yadav, MD Registrar, Department of Anesthesia Civil Service Hospital, Min Bhawan, Kathmandu 44600, Nepal Email: rupesh905@hotmail.com analgesic may lead to inadeqaute pain control resulting in the usage of high dosage of opioids. To overcome this disadvantage there is increasing experience with the use of ultrasound guided indwelling catheters placement for the provision of postoperative analgesia. This case report emphasizes the importance of the Transverse Abdominal Plane (TAP) block to provide perioperative analgesia in pregnant patient with WPW syndrome
Summary
Rupesh Kumar Yadav, Anuj Jung Rayamajhi, Prajjwal Raj Bhattarai, Subash Chandra Paudel.
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