Abstract
Some of the changes reported in the ECG of parturients undergoing Caesarean section are suggestive of myocardial ischaemia. This study determined serum CK total and the isoenzyme CK-MB levels in 21 patients during and after Caesarean section under epidural anaesthesia. Twenty patients complained of chest pain, discomfort and pressure, while 12 had ST segmental depression. Although the total CK activity in ten patients was elevated, CK-MB activity in all patients was negative. The electrocardiographic changes were rate-related and occurred at the time pressure was placed upon the upper abdomen and lower thoracic cage by the surgeon to facilitate Caesarean delivery. The data from this study demonstrate that no myocardial injury as measured by CK-MB activity occurs in parturients undergoing Caesarean delivery despite the complaint of chest pain, discomfort and pressure, and ST changes in the ECG.
Résumé
Certains changements observés sur l’ECG de parturientes soumises à une césarienne suggèrent l’ischémie myocardique. Ce travail évalue les niveaux de la CK sérique totale et de l’enzyme CPK-MB chez 21 patientes pendant et après la césarienne sous anesthésie épidurale. Vingt patientes se sont plaintes de douleurs thoraciques, de sensation d’inconfort et de serrement, alors que 12 présentaient une dépression du segment ST. Bien que l’activité totale de la CK chez six patientes ait été élevée, l’activité de la CPK-MB était négative chez toutes les patientes. Les changements à l’ECG étaient reliés à la fréquence et sont survenus au moment où la pression était appliquée sur l’abdomen supérieur et sur la cage thoracique inférieure par le chirurgien pour faciliter l’extraction. Les données de cette étude prouvent qu’il y a absence de lésion myocardique comme le démontre l’activité de la CPK-MB chez des parturientes soumises à l’extraction par césarienne malgré la description de douleur thoracique, de sensation d’inconfort et de serrement, et l’observation de changements du segment ST à l’ECG.
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Palmer CM, Norris MC, Giudici MC, Leighton BL, DeSimone CA. Incidence of electrocardiographic changes during cesarean delivery under regional anesthesia. Anesth Analg 1990; 70: 36–43.
Mathew JP, Fleisher LA, Rinehouse JA, et al. ST segment depression during labour and delivery. Anesthesiology 1992; 77: 635–41.
McLintic AJ, Pringle SD, Lilley S, Houston AB, Thornburn J. Electrocardiographic changes during cesarean section under regional anesthesia. Anesth Analg 1992; 74: 51–6.
Weinberger I, Fuchs J, Rotenberg Z, Davidson E, Harel D, Agmon J. Changes in creatine kinase activity in the course of acute myocardial infarction. Clin Chem 1989; 35: 414–6.
Tsung SH. Several conditions causing elevation of serum CK-MB and CK-BB. Am J Clin Pathol 1981; 75: 711–5.
Eisenberg PR, Shaw D, Schaab C, Jaffe AS. Concordance of creatine kinase-MB activity and mass. Clin Chem 1989; 35: 440–3.
Grayzel J. A statistic for inferences is based upon negative results (Letter). Anesthesiology 1989; 71: 320–1.
Malinow AM, Naulty JS, Hunt CO, Datta S, Osterheimer GW. Precordial ultrasonic monitoring during cesarean delivery. Anesthesiology 1987; 66: 816–9.
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Ross, R.M., Baker, T. Cardiac enzymes in patients undergoing caesarean section. Can J Anaesth 42, 46–50 (1995). https://doi.org/10.1007/BF03010571
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DOI: https://doi.org/10.1007/BF03010571