Combined spinal-epidural anesthesia for cesarean section in a patient with Moyamoya disease -A case report-

Abstract

Moyamoya disease is a rare progressive occlusive disease of the internal carotid arteries. We report a case of combined spinal-epidural anesthesia in a patient with Moyamoya disease presenting for Cesarean section. Hypotension associated with spinal anesthesia for Cesarean section is the most common and serious adverse effect despite the use of uterine displacement and volume preload. We continuously infused phenylephrine and ephedrine to prevent hypotension. The intraoperative hemodynamic state was stable. The patient had no significant postoperative complications.

Keywords: Combined spinal-epidural anesthesia; Ephedrine; Moyamoya disease; Phenylephrine.