Application of cerebral oximetry for a parturient with Takayasu's arteritis undergoing cesarean section -a case report

• Published in: Korean journal of anesthesiology Vol. 65; no. 2; pp. 158 - 162
• Main Authors: Lee, Eun Hye, Choi, Eunsu, Ahn, Wonsik
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Anesthesiologists 01-08-2013; Korean Society of Anesthesiologists; 대한마취통증의학회
• Subjects: Case Report; cerebral oximetry; cesarean section; epidural anesthesia; near-infrared spectroscopy; takayasu's arteritis; 마취과학; Cerebral oximetry; Takayasu's arteritis; Cesarean section; Epidural anesthesia; Near-infrared spectroscopy
• ISSN: 2005-6419; 2005-7563
• DOI: 10.4097/kjae.2013.65.2.158

Takayasu's arteritis (TA) is a chronic inflammatory disease involving the aorta. Because TA sometimes involves cerebral arteries, anesthetic debates focus on cerebral monitoring. There is limited evidence as to which cerebral monitoring method is most adequate. Furthermore, there is insufficient evidence to determine which anesthetic technique is better for TA parturients. We experienced the case of a TA parturient who developed transient cerebral ischemia during cesarean section. The patient's TA involved her cerebral arteries, and her regional cerebral oxygen saturation (rSO2) was lower in the left side than in the right side. She complained of speech impairment, tinnitus, and stiffness of the posterior neck when the rSO2 levels dropped. The FloTrac/Vigileo™ system did not correlate with clinical symptoms, but the cerebral oximeter displayed the low oxygen saturation. We recommend the cerebral oximetry for cerebral monitoring in TA parturients who undergo cesarean sections, especially in hemodynamically unstable patients under regional anesthesia or unconscious patients under general anesthesia.