Ultrasound-assisted neuraxial anaesthesia and intra-operative non-invasive ventilation for emergency caesarean section in a parturient with profound respiratory failure: A case report

Abstract

Here we describe the perioperative management of a patient with profound respiratory failure. A 32-year-old parturient presented with acute-on-chronic respiratory failure at 30 weeks' gestation. Her deterioration was attributed to advancing gestation on a background of significant respiratory comorbidity and required emergency caesarean section. Anaesthesia for a safe operative delivery was predicted to be difficult, carrying significant risk for both patient and fetus. We describe the successful use of intra-operative non-invasive ventilation and ultrasound-assisted neuraxial anaesthesia in order to facilitate emergency caesarean section without general anaesthesia.

Keywords

• combined spinal-epidural
• non-invasive ventilation
• obstetric anaesthesia
• respiratory failure
• ultrasound-assisted neuraxial anaesthesia