Management of pregnancy and delivery in women with Kawasaki disease and residual coronary artery lesion with detailed analysis of labor analgesia: combined experience of 13 cases in two institutions

Inoue, Rie; Mazda, Yusuke; Tanaka, Hiroaki; Tanaka, Kayo; Yoshimatsu, Jun; Tamura, Kazumi; Terui, Katsuo

doi:10.1186/s40981-020-00375-y

JA Clinical Reports

Table 2 Anesthetic and obstetric details

From: Management of pregnancy and delivery in women with Kawasaki disease and residual coronary artery lesion with detailed analysis of labor analgesia: combined experience of 13 cases in two institutions

Vaginal delivery
Case ID	Indication of neuraxial analgesia	Labor/mode	Technique	Monitoring	Neuraxial modality
2	Physician recommendation	Spontaneous NSVD	Epidural	ECG, NIBP, SpO2, IBP	CEI 0.1% Ropivacaine
3 (#1)	Physician recommendation	Spontaneous NSVD	Epidural	EGC, NIBP, SpO2	CEI 0.1% Ropivacaine
3 (#2)	Patient requirements	Spontaneous Forceps	Epidural	EGC, NIBP, SpO2	CEI0.1% Ropivacaine
4 (#1)	Physician recommendation	Spontaneous Forceps	Epidural	ECG, IBP	PIEB+PCEA 0.1% Ropivacaine
4 (#2)	Physician recommendation	Spontaneous NSVD	None	None	N/A
5 (#1)	Physician recommendation	Induced Forceps	Epidural	ECG, NIBP, SpO2	IEB, 1% Lidocaine and 0.25% Ropivacaine
5 (#2)	Physician recommendation	Induced Forceps	Epidural	ECG, NIBP, SpO2	IEB, 1% Lidocaine & 0.25% Ropivacaine
6	Physician recommendation	Spontaneous Forceps	Epidural	ECG, NIBP, SpO2, CVP(post-partum)	IEB, 1% Lidocaine
8	Physician recommendation	Spontaneous NSVD	Epidural	ECG, NIBP, SpO2, IBP, CVP	IEB, 1% Lidocaine
9 (#1)	Physician recommendation	Spontaneous Forceps	Epidural	ECG, NIBP, SpO2	CEI 0.1% Ropivacaine
9 (#2)	Physician recommendation	Induced vacuum	Epidural	ECG, NIBP, SpO2	CEI 0.1% Ropivacaine
11	Physician recommendation	Spontaneous Vacuum	Epidural	ECG, NIBP, SpO2	IEB, 1% Lidocaine
Cesarean delivery
Case ID	Indication of cesarean delivery	Urgency	Anesthesia	Monitoring	Anesthetic management
1	Failure to progress	Urgent	Epidural	ECG, NIBP, SpO2, IBP, PAC, TTE	Dopamine infusion for hypotension
7 (#1)	Chest discomfort	Elective	General	ECG, NIBP, SpO2, IBP	Prophylactic ISDN
7 (#2)	Repeat	Elective	CSEA	ECG, NIBP, SpO2	Prophylactic ISDN
10 (#1)	Failure to progress	Urgent	CSEA	ECG, NIBP, SpO2	Ephedrine bolus for hypotension
10 (#2)	Repeat	Elective	CSEA	ECG, NIBP, SpO2	Ephedrine bolus for hypotension
12	NSVT	Elective	CSEA	ECG, NIBP, SpO2	Ephedrine and phenylephrine bolus for hypotension, lidocaine infusion
13	Breech presentation	Elective	CSEA	ECG, NIBP, SpO2	Ephedrine and phenylephrine bolus for hypotension, PDPH

NSVD normal spontaneous vaginal delivery, NIBP non-invasive blood pressure, IBP invasive blood pressure (arterial line), CEI continuous epidural infusion, PIEB programmed intermittent epidural bolus, PCEA patient control epidural analgesia, IEB intermittent manual epidural bolus, CVP central venous pressure, PAC pulmonary artery catheter, TTE transthracic echocardiogram, ISDN isosorbide dinitrate, CSEA combined spinal epidural anesthesia, NSVT non-sustained ventricular tachycardia, PDPH post-dural puncture headache

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