Saeki

CSEA at T12-L1 level.

ED: none. SD: 2.2 mL 0.5%

isobaric Bup

MV

regurgitation,

aortic

dissection

Suitable

blockage

at T6 level

Aortic dissection managed with

medical treatment

Baghirzada

Case 1:

epidural catheter at L3-L4.

Spinal puncture at L4-L5 interspace.

SD: 0.75% hyperbaric Bup 9 mg.

ED: Bup 0.5% 150 mg

Case 2:

epidural catheter at L2-L3 level.

SD: 0.75% hyperbaric Bup

13.5 mg + fentanyl 10 μg +

morphine 100 μg

Case 1:

dilated aortic

root (42 mm),

MV prolapse,

bicuspid AV,

significant

DE (lumbar

dural sac area

of 4.71 cm2),

cervicothoracic

scoliosis

Case 2:

moderate DE

(lumbar dural

sac area of

3.61 cm2),

dilated aortic

root (45 mm)

Case 1:

suitable block

(ED anesthetic

titrated during

15 min for

reaching

T4 level)

Case 2:

suitable block

(bilateral T5

sensory level

obtained after

15 min,

catheter not

used for

anesthesia)

Case 1:

used NCOM.

Baseline SP was

maintained with

phenylephrine EV

boluses of 0.1 mg.

Aortic root

repairing surgery

five days after CS

Case 2:

used NCOM

Clayton

Reported 7 cases managed

with CSEA.

Inadequate blocks received:

SD: 0.5% hyperbaric Bup 2.8 mL

(mean initial dose)

(range 1.5-4 mL) + opioids

—

5 blocks were

inadequate: 4

of the 5 CSEA

parturients

required

additional

measures

despite having

received ED

Additional

measures:

1 patient received

general anesthesia,

1 repeated spinal,

2 EV opiates

Heck

(only

CSEA

cases)

Case 1:

ED: none. SD: Bup 17.5 mg

+ DM 300 μg

Case 2:

ED: 0.5% L-Bup 10 mL.

SD: Bup 10 mg + DM 300 μg

Case 3:

SD: Bup 7.5 mg.

ED: 0.5% Bup 5 mL

Case 4:

SD: Bup 12.5 mg + DM 300 μg.

ED: 2% lidocaine 5 mL + 0.5%

L-Bup 10 mL

Case 5:

SD: Bup 14 mg + DM 300 μg.

ED: none

Case 6:

SD: Bup 17 mg + DM 300 μg.

ED: 0.5% L-Bup 23 mL

Case 7:

SD: Bup 14 mg + DM 300 μg.

ED: 0.5% L-Bup 10 mL

+ 2% lidocaine (plus adrenaline/

bicarbonate) 10 mL

Case 1:

aortic

dilatation

(42 mm)

Case 5:

aortic

dilatation

(59 mm)

Case 1-2:

adequate

blocks

Cases 3-7:

inadequate

blocks

Case 4:

converted to

general anesthesia

Case 7:

repeated

spinal anesthesia

(0.5% Bup 1 mL)

Cases 3 and 5-7:

supplementary

analgesia

with alfentanil

Cases 5-7:

received

nitrous oxide

Sakurai

ED (T12-L1 interspace):

10 mL normal saline

+ 2% lidocaine 10 mL

per catheter (twice).

SD (L3-L4 interspace):

0.5% hyperbaric Bup 11 mg

+ fentanyl 10 μg

Aortic root

dilatation

(39 mm),

DE, scoliosis

Adequate

sensory block

at T11-T6

(beginning

and end of

surgery,

respectively)

4 mg ephedrine

for one episode

of hypotension. Hypesthesia and

severe postdural

puncture headache

after CS

Yang

SD: 0.5% hyperbaric Bup 8 mg

+ 10 μg fentanyl.

ED: 2% lidocaine 8 mL

+ 0.75% ropivacaine 8 mL

per catheter

(titrated over 20 min)

Aortic

regurgitation

(repaired

aortic root

aneurysm

during

childhood)

Adequate

sensory block

at T4 level

SP above

100 mmHg

(invasive)

maintained with

ephedrine 4 mg EV

(twice)

Coffman

SD: 0.75% Bup 0.5 mL

+ fentanyl 15 μg +

morphine 100 μg

(L3-L4 interspace).

ED: 2% lidocaine +

1:200,000 epinephrine 5 mL

(4 doses) in 10 min (1st catheter).

2-chloroprocaine 5 mL

(4 doses) in 10 min (2nd catheter,

L2-L3 interspace)

Aortic root

replacement

caused

by aortic

dissection

one year

before CS

Failed block.

converted

to general

anesthesia.

CS performed

in lateral

decubitus

position

Monitored

invasive pressure.

Phenylephrine EV

infusion

(25-50 μg/min) +

20 μg of epinephrine

(two episodes of

hypotension)