International Journal of Obstetric Anesthesia
Volume 18, Issue 3 , Pages 262-267 , July 2009

Cesarean section and primary pulmonary hypertension: the role of intravenous dexmedetomidine

  • H. Toyama

      Affiliations

    • Department of Anesthesiology, Center for Translational and Advanced Animal Research, Tohoku University School of Medicine, Sendai, Japan
    • ,
  • T. Wagatsuma

      Affiliations

    • Department of Anesthesiology, Center for Translational and Advanced Animal Research, Tohoku University School of Medicine, Sendai, Japan
    • ,
  • Y. Ejima

      Affiliations

    • Department of Anesthesiology, Center for Translational and Advanced Animal Research, Tohoku University School of Medicine, Sendai, Japan
    • ,
  • M. Matsubara

      Affiliations

    • Division of Molecular Medicine, Center for Translational and Advanced Animal Research, Tohoku University School of Medicine, Sendai, Japan
    • ,
  • S. Kurosawa

      Affiliations

    • Department of Anesthesiology, Center for Translational and Advanced Animal Research, Tohoku University School of Medicine, Sendai, Japan
    • Corresponding Author InformationCorrespondence to: Shin Kurosawa, MD, PhD, Department of Anesthesiology, Tohoku University Hospital, 1-1 Seiryo-cho, Aoba-ku, Sendai 980-8574, Japan.

,Accepted 26 August 2008.

References 

  1. Rubin LJ. Primary pulmonary hypertension. N Engl J Med. 1997;336:111–117
  2. D’Alonzo GE, Barst RJ, Ayres SM, et al. Survival in patients with primary pulmonary hypertension: results from a national prospective registry. Ann Intern Med. 1991;115:343–349
  3. McCaffrey RN, Dunn LH. Primary pulmonary hypertension in pregnancy. Obstet Gynecol Surv. 1964;19:567–591
  4. Weiss BM, Zemp L, Seifert B, et al. Outcome of pulmonary vascular disease in pregnancy: a systematic overview from 1978 through 1996. J Am Coll Cardiol. 1998;31:1650–1657
  5. Elkayam U, Gleicher N. Cardiac Problems in Pregnancy. 3rd edition. New York, NY: Wiley-Liss; 1998;183–90
  6. Aantaa R, Jalonen J. Perioperative use of alpha2-adrenoceptor agonists and the cardiac patient. Eur J Anaesthesiol. 2006;23:361–372
  7. Mukoyama M, Nakao K, Hosoda K, et al. Brain natriuretic peptide as a novel cardiac hormone in humans. Evidence for an exquisite dual natriuretic peptide system, atrial natriuretic peptide and brain natriuretic peptide. J Clin Invest. 1991;87:1402–1412
  8. Leuchte HH, Holzapfel M, Baumgartner RA, et al. Clinical significance of brain natriuretic peptide in primary pulmonary hypertension. J Am Coll Cardiol. 2004;43:764–770
  9. Nagaya N, Nishikimi T, Uematsu M, et al. Plasma brain natriuretic peptide as a prognostic indicator in patients with primary pulmonary hypertension. Circulation. 2000;102:865–870
  10. Wiedemann R, Ghofrani HA, Weissmann N, et al. Atrial natriuretic peptide in severe primary and nonprimary pulmonary hypertension: response to iloprost inhalation. J Am Coll Cardiol. 2001;38:1130–1136
  11. Leuchte HH, Holzapfel M, Baumgartner RA, Neurohr C, Vogeser M, Behr J. Characterization of brain natriuretic peptide in long-term follow-up of pulmonary arterial hypertension. Chest. 2005;128:2368–2374
  12. Power K, Avery A. Extradural analgesia in the intrapartum management of a patient with pulmonary hypertension. Br J Anaesth. 1989;63:116–120
  13. Johnsson MD, Saltzman DH. Cardiac disease. In:  Datta S editors. Anesthetic and Obstetric Management of High-Risk Pregnancy. St. Louis: Mosby-Year Book, Inc.; 1991;p. 245–251
  14. Khan MJ, Bhatt SB, Kryc JJ. Anesthetic considerations for parturients with primary pulmonary hypertension: review of the literature and clinical presentation. Int J Obstet Anesth. 1996;5:36–42
  15. Sitbon O, Humbert M, Jagot JL, et al. Inhaled nitric oxide as a screening agent for safely identifying responders to oral calcium-channel blockers in primary pulmonary hypertension. Eur Respir J. 1998;12:265–270
  16. But AK, Ozgul U, Erdil F, et al. The effects of pre-operative dexmedetomidine infusion on hemodynamics in patients with pulmonary hypertension undergoing mitral valve replacement surgery. Acta Anaesthesiol Scand. 2006;50:1207–1212
  17. Kutter AP, Kastner SB, Bettschart-Wolfensberger R, Huhtinen M. Cardiopulmonary effects of dexmedetomidine in goats and sheep anaesthetised with sevoflurane. Vet Rec. 2006;159:624–629
  18. Kastner SB, Kull S, Kutter AP, Boller J, Bettschart-Wolfensberger R, Huhtinen MK. Cardiopulmonary effects of dexmedetomidine in sevoflurane-anesthetized sheep with and without nitric oxide inhalation. Am J Vet Res. 2005;66:1496–1502
  19. Ebert TJ, Hall JE, Barney JA, Uhrich TD, Colinco MD. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology. 2000;93:382–394
  20. Hodgkinson R, Husain FJ, Hayashi RH. Systemic and pulmonary blood pressure during caesarean section in parturients with gestational hypertension. Can Anaesth Soc J. 1980;27:389–394
  21. Guler G, Akin Z, Tosun E, Eskitascoglu E, Mizrak A, Boyaci A. Single-dose dexmedetomidine attenuates airway and circulatory reflexes during extubation. Acta Anaesthesiol Scand. 2005;49:1088–1091
  22. Sia AT, Kwek K, Yeo GS. The in vitro effects of clonidine and dexmedetomidine on human myometrium. Int J Obstet Anesth. 2005;14:104–107
  23. Ala-Kokko TI, Pienimäki P, Lampela E, Hollmén AI, Pelkonen O, Vähäkangas K. Transfer of clonidine and dexmedetomidine across the isolated perfused human placenta. Acta Anaesthesiol Scand. 1997;41:313–319
  24. Van de Velde M, Teunkens A, Kuypers M, Dewinter T, Vandermeersch E. General anaesthesia with target controlled infusion of propofol for planned caesarean section: maternal and neonatal effects of a remifentanil-based technique. Int J Obstet Anesth. 2004;13:153–158
  25. Wadsworth R, Greer R, MacDonald JM, Vohra A. The use of remifentanil during general anaesthesia for caesarean delivery in two patients with severe heart dysfunction. Int J Obstet Anesth. 2002;11:38–43
  26. Orme RM, Grange CS, Ainsworth QP, Grebenik CR. General anaesthesia using remifentanil for caesarean section in parturients with critical aortic stenosis: a series of four cases. Int J Obstet Anesth. 2004;13:183–187
  27. Macfarlane AJ, Moise S, Smith D. Caesarean section using total intravenous anaesthesia in a patient with Ebstein’s anomaly complicated by supraventricular tachycardia. Int J Obstet Anesth. 2007;16:155–159
  28. Draisci G, Valente A, Suppa E, et al. Remifentanil for cesarean section under general anesthesia: effects on maternal stress hormone secretion and neonatal well-being: a randomized trial. Int J Obstet Anesth. 2008;17:130–136
  29. Resnik JL, Hong C, Resnik R, et al. Evaluation of B-type natriuretic peptide (BNP) levels in normal and preeclamptic women. Am J Obstet Gynecol. 2005;193:450–454
  30. Nanno H, Sagawa N, Itoh H, et al. Nitric oxide metabolite concentrations in maternal plasma decrease during parturition: possible transient down-regulation of nitric oxide synthesis. Mol Hum Reprod. 1998;4:609–616
  31. Yoshimura T, Yoshimura M, Yasue H, et al. Plasma concentration of atrial natriuretic peptide and brain natriuretic peptide during normal human pregnancy and the postpartum period. J Endocrinol. 1994;140:393–397
  32. National Institutes of Health (NIH) Consensus Development Panel . Effect of corticosteroids for fetal maturation on perinatal outcomes. Am J Obstet Gynecol. 1995;173:246–252

PII: S0959-289X(08)00139-8

doi: 10.1016/j.ijoa.2008.08.001

International Journal of Obstetric Anesthesia
Volume 18, Issue 3 , Pages 262-267 , July 2009

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