[Continuous epidural anesthesia for cesarean section in a patient with Takayasus arteritis: case report].

BACKGROUND AND OBJECTIVES: Continuous epidural anesthesia with titrated doses of local anesthetics is safe and effective for patients not tolerating blood pressure fluctuations. This report aimed at presenting a case in which continuous epidural anesthesia for Cesarean section in a patient with Takayasus arteritis was successfully induced.

CASE REPORT: Primiparous patient, 25 years old, 63 kg, Takayasus arteritis, 34 to 35 weeks of gestation, acute fetal distress, blood pressure = 155/85, HR = 92, no carotid, upper and right lower limb pulse. Patient had only left palpable popliteal pulse. Epidural continuous anesthesia was induced with 25 mg titrated doses of 0.5% bupivacaine with epinephrine (1:200.000), in 5-minute intervals, up to a total dose of 100 mg with 2 mg morphine and 100 microg fentanyl.

CONCLUSIONS: Continuous epidural anesthesia with titrated doses of 0.5% bupivacaine may be used in patients with Takayasus arteritis, provided all precaution measures are taken with such patients.