Journal of Anaesthesia and Pain
Vol 3, No 3 (2022): September

Epidural Anesthesia Management in Cesarean Section with Placenta Accreta

Aura Ihsaniar (Department of Anesthesiology and Intensive Therapy, RSUD Dr. Moewardi Surakarta, Medical Faculty Sebelas Maret University, Indonesia)
Pandu Anggoro (Department of Anesthesiology and Intensive Therapy, RSUD Dr. Moewardi Surakarta, Medical Faculty Sebelas Maret University, Indonesia)



Article Info

Publish Date
30 Sep 2022

Abstract

Background: In pregnant women, the spectrum of placenta accreta is considered a high risk syndrome. Placenta accreta is responsible for 7-10% of all maternal deaths worldwide. This study reports on a patient with placenta accreta who underwent a cesarean section using epidural anesthesia.Case: A 30-year-old woman (Gravida: 3, Abortus: 1, Partus: 1) with a gestational age of 8 months came to the hospital.  with 8 months of gestation was diagnosed with antepartum hemorrhage et causa placenta previa totalis morbidly adherent placenta high risk with planned elective cesarean section with bilateral tubectomy to hysterectomy, Double J (DJ) stent, Ballooning using epidural anesthesia with physical American Society of Anesthesiologists (ASA) II status. Local anesthetic with 2% lidocaine 2 ml, 12 ml of 0.5% bupivacaine given in incremental doses of 4 ml every 5 minutes while monitoring the patient's hemodynamics. Intraoperative drugs consist of intravenous (IV) dexamethasone 5 mg IV, ondansetron 8 mg IV, tranexamic acid 1 gram, paracetamol 1 gram IV, bupivacaine 0.5% 3ml every 1 hour via an epidural catheter. Maintenance using O2 3 lpm. The operation lasted 450 minutes, with stable outcome both maternal and fetal.Conclusion: Anesthesia management in patients with bleeding during labor is very important. In this case, epidural anesthesia provide a good outcome in maternal and fetal after cesarean section in placenta accreta patient. 

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Journal Info

Abbrev

jap

Publisher

Subject

Health Professions Medicine & Pharmacology

Description

Journal of Anaesthesia and Pain is a peer-reviewed and open-access journal that focuses on anesthesia and pain. Journal of Anaesthesia and Pain, published by Anesthesiology and Intensive Therapy Specialist Program of Medicine Faculty, Brawijaya University. This journal publishes original articles, ...