Cesarean Section In a Patient With Wolff-Parkinson-White Syndrome Under Spinal Anesthesia

Year 2013, Volume: 15 Issue: 1, 66 - 67, 01.03.2013

İsmail Aydın Erden Banu Ayhan Özgür Canbay Ülkü Aypar İlker Öngüç Aycan

Abstract

Maternal arrhythmias during pregnancy may be life-threatening. Several studies demonstratethat pregnancy predisposes maternal arrhythmias in asymptomatic patients with WolffParkinson-White syndrome. The presence of an accessory pathway may responsible forWolff-Parkinson-White syndrome. Regional anesthesia induced sympathetic blockade causes aprompt decrease in atrial filling pressure and this process results in increased disrhythmia.Autonomic, hemodynamic and hormonal changes may predispose to arrhythmias in pregnancy.Hormonal changes especially abrupt changes in serum levels of estrogens are thought to beresponsible in the development of arrhythmias during pregnancy. This case report describes apregnant woman with Wolff-Parkinson-White syndrome under spinal anesthesia for cesareandelivery surgery

Keywords

Anesthesia, Spinal, Wolff-Parkinson-White Syndrome

Spinal Anestezi Altında Wolff-Parkinson-White Sendromlu Hastada Sezeryan Ameliyatı

Abstract

Gebelikte olan maternal aritmiler yaşamı tehdit edebilmektedir. Bir çok çalışmada, WolffParkinson-White sendromlu asemptomatik hastalarda gebeliğin maternal aritmilere yatkınlığıarttırdığı bildirilmiştir. Wolff-Parkinson-White sendromundan aksesuar yolların var oluşusorumlu olabilir. Rejional anestezi sırasındaki sempatik blokaj atrial dolum basıncında hızlıazalmaya ve bu da artan disritmilere neden olur. Gebelerdeki otonomik, hemodinamik vehormonal değişiklikler aritmiye yol açabilir. Hormonal değişiklikler, özellikle östrojenin serumseviyesindeki ani değişikliklerin gebelik sırasındaki aritmilerin gelişmesinden sorumluolabileceği düşünülmektedir. Bu olgu sunumunda Wolff-Parkinson-White sendromlu gebe birbayanda spinal anestezi altında sezeryan ameliyatını tartıştık

Keywords

Anestezi, Spinal, Wolff-Parkinson-White Sendromu

References

• Okamoto T, Minami K, Shiraishi M, Ogata J, Shigematsu A. Repeated supraventricular tachycardia in an asymptomatic patient with Wolff-Parkinson-White syndrome during Cesarean delivery. Canadian Journal of Anesthesia. 2003, 50(7):752-3.
• Gunusen I, Karaman S, Toz Z, Aliyeva A, Firat V: Suddenly developed atrial fibrillation during caesarean section. Wolff- parkinson-white syndrome. Turkiye Klinikleri J Anest Reanim. 2007, 5(3):158-160.
• Timmermans C, Smeets JL, Rodriguez LM, Vrouchos G, van den Dool A, Wellens HJ. Aborted sudden death in the Wolff- parkinson-white syndrome. The American Journal of Cardiology. 1995, 76(7):492-4.
• Zijl DHSV, Dyer RA, Millar RNS, James MFM. Supraventricular tachycardia during spinal anaesthesia for caesarean section. International Journal of Obstetric Anesthesia. 2001, 10(3):202–205.
• Nishikawa K, Mizoguchi M, Yukioka H, Asada A, Fujimori M. Concealed Wolff-parkinson-white syndrome detected during spinal anaesthesia. Anaesthesia. 1993, 20; 48(12): 1061-64.
• Sprague DH, Mandel SD. Paroxysmal supraventricular tachycardia during anesthesia. Anesthesiology. 1977, 46(1):75–77.
• Chow T, Galvin J, McGovern B. Antiarrhythmic drug therapy in pregnancy and lactation. Am J Cardiol. 1998, 82(4A): 581– 621.
• Gleicher N, Meller J, Sandler RZ, Sullum S. Wolff-Parkinson- White syndrome in pregnancy. Obstet Gynecol. 1961, 58:748-52.
• Roberts JM, Insel PA, Goldfien A. Regulation of myometrial adrenoreceptors and adrenergic response by sex steroids. Molecular Pharmacology. 1981, 20(1):52-8.
• Metz A, Stump K, Cowen PJ, Elliott JM, Gelder MG, Grahame-Smith DG. Changes in platelet alpha-2- adrenoreceptor binding postpartum: possible relation to maternity blues. Lancet. 1983, 5;1(8323)1:495-8.
• Schwartz PJ, Priori SG. Sympathetic nervous system and cardiac arrhythmias. In: Zipes PD, Jalife J (eds): Cardiac electrophysiology: From cell to bedside. 1 st ed. Philadelphia: WE Saunders Co, pp.330-43, 1990.
• Hensleigh PA, Brown EL. Psychosocial stress and pregnancy. In: Gleicher N (ed). Principle of medical therapy in pregnancy. 1 st ed. New York: Plenum Medical Book Company, pp.885- 8, 1985.