Anesthetic management of a parturient undergoing cesarean section with a XXXX and hemoptysis.

@entity1 @entity4388 @entity9855 @entity1353 @entity5 @entity1576 @entity299 @entity1173
Anesthetic management of a parturient with @entity1576 associated with hemoptysis, @entity1353 , and orthopnea is difficult. An anesthesiologist should realize that the @entity1 ' @entity9855 problem is not solved during the surgery. This circumstance is similar to a @entity1 with associated @entity299 scheduled for non-cardiac surgery. General anesthesia with endotracheal intubation can provide safe oxygenation for both the parturient and the fetus, but with possible unexpected massive hemoptysis and @entity5 seeding. Prolonged intubation may delay the @entity1 's pulmonary treatment course. Laryngeal mask anesthesia can provide an airway, but must not be secured due to the risk of @entity1173 . The need of high doses of inhalation drugs may hinder uterine contractions. The addition of a muscle relaxant will change the @entity1 's respiratory patterns and physiology. Regional anesthesia alone might not be tolerated. A decrease in cough strength, as well as @entity1353 , orthopnea, and hyperventilation may be harmful to both the parturient and the fetus. However, we successfully managed this case using epidural anesthesia combined with assisted mask ventilation instead of spontaneous breathing usually provided by a simple mask in almost all American Society of Anesthesiology (ASA) class I-II parturients during cesarean section. The anesthetic level was maintained at T8 with 18 ml of 2% Xylocaine mixed with 2 ml of 7% @entity4388 with 1:200,000 epinephrine epidurally and with the @entity1 in a supine position with the head up at 30 degrees to prevent cephalic spreading and to ensure better pulmonary ventilation.
