Combined-spinal-epidural anesthesia in a parturient with gestational hypertension with acute and extremely elevated blood pressure undergoing emergency caesarean section

Abstract

Hypertensive disorder is the most common medical problem encountered in pregnancy. It remains an important cause of maternal, and foetal, morbidity and mortality. Neuraxial anaesthesia techniques are most widely used for caesarean delivery. We describe the anaesthetic management of a 40-year-female with gestational hypertension undergoing caesarean section who presented with acute and extreme rise of blood pressure (BP) (249/116 mmHg). Her BP was controlled quickly and she was successfully managed by combined-spinal-epidural technique. This report shows that carefully conducted neuraxial anaesthesia can be useful for caesarean delivery in parturients with severe elevation of BP where general anaesthesia is normally indicated.