Anaesthesia for a Patient with Severe Pulmonary Hypertension Coming for Cesarean Section: A Case Report

Pulmonary hypertension(PH) creates a significant challenge for the anesthesiologist, placing patients in high risk category. PH is a major reason for elevated perioperative morbidity and mortality, even in non cardiac surgical procedures. Stress, pain, ventilation, surgical related inflammation, can further increase pressure within pulmonary arteries and cause right heart failure. The major concern with PH is the development of right heart failure. These patients will be on various drugs. Either epidural or general anesthesia(GA) can be used, regional anesthesia is considered better. In GA, induction should be carried out slowly and doses should be titrated to avoid fall in systemic blood pressure. GA is preferred in later stages of PH or in severe cases, along with regional anaesthesia. The main advantage of GA is safe oxygenation and uncomplicated airway management, also inhalants for selective pulmonary vasodilatation can be administered easily. Here we report a case of severe primary PH, coming for caesarian section, managed under GA.