Anaesthetic Management Goals
The haemodynamic goals in MS for LSCS
Anaesthetic management goals
Maintain preloadJudicious fluids; the stenotic valve needs a full atrium
Prevent changes in afterload
Control heart rateAvoid tachycardia (shortens diastole) AND bradycardia
Avoid ↑ PVRAvoid hypoxia, hypercarbia, acidosis, light planes of anaesthesia
Maintain SVRAvoid hypotension & the effects of neuraxial sympathectomy
Maintain sinus rhythmPreserve the atrial kick; treat AF promptly
Avoid aortocaval compressionLeft-lateral tilt / wedge — protect venous return & uteroplacental perfusion
Monitoring
SpO₂, ECG, NIBP as baseline; add invasive arterial line (IBP) and CVP in severe MS; cardiac-output monitoring in sick patients; urine output & temperature; neuromuscular monitoring; and consider pulmonary-artery catheterisation in selected severe cases.