Transverse Abdominal Plane Block (Tap Block) Echo-guide a Safe Alternative for Cesarean in Parturients with a Precarious Hemodynamic State: About a Case of "Beautiful Escape"
2023; Volume: 7; Issue: 7 Linguagem: Inglês
10.31080/asps.2023.07.0963
ISSN2581-5423
AutoresKamissoko Mohamed S, K Soumano, N Bagayogo, Kuan Abdoulaye Traoré, M Shabani, B Traoré, Souleymane Coulibaly, D Traoré, P Coulibaly, Sulaiman Bah, I Bamba,
Tópico(s)Cardiovascular Issues in Pregnancy
ResumoAnesthesia for emergency caesarean section constitutes a real challenge for the anesthetist-resuscitator not only because of the complexity linked to the physiology of the pregnant woman but also because of the delay in fetal extraction, especially since the patient would be in a unstable haemodynamic status (HDM).In our case, it is a 26-year-old patient, housewife, married, with no known medical-surgical history (G3, P2) with two living children (V2), having carried out no prenatal consultation, a Glasgow at 14 /15 on admission associated with an unstable haemodynamic state.She was operated by Caesarean section for hemorrhage in the third trimester of pregnancy lasting more than 24 hours in a pregnancy estimated at term.We performed bilateral ultrasoundguided TAP BLOCK with 0.8 ml/ KgP of 0.25% Levo-Bupivacaine plus local infiltration of the incision site with 10 ml of XYLOCAINE 20 mg/ml ADRENALINE 0.005 mg/ml.Verbal contact was maintained with the patient throughout the surgery and she kept a stable HDM state intraoperatively with a mean arterial pressure (MAP) of 70 mmHg at the end of the procedure.Wall BLOCK techniques are feasible, reliable and beneficial on fragile sites where general anesthesia and neuro-axial methods (epidural or intrathecal) are contraindicated or even dangerous.
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