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Hyperaldosteronism Primary

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Question: What is the anesthesia technique of choice for cesarian section in patient with primary hyperaldosteronism?

Answer: My recommendation is to use epidural anesthesia. Usually, I prefer spinals for Cesarean deliveries, because I like the quick onset and density of the block. However, because of the hypertension associated with hyperaldosteronism, I would like to raise the level of the block slowly, so that I could compensate for the decrease in blood pressure that occurs with the block. Prior to any anesthetic, electrolytes should be checked and corrected, if necessary. It may be advisable to admit the patient the night before a planned Cesarean to adequately control blood pressure and electrolytes. Anti-hypertensive medications should be continued throughout the peri-operative period. General anesthesia can also be done, but is riskier for any pregnant patient, so that would not be my first choice. Hope that helps.

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