[Cesarean section, mitral valve disease and pulmonary hypertension. Implications of hemodynamic monitoring on anesthetic management]. / Césarienne, maladie mitrale et hypertension artérielle pulmonaire. Implications du monitorage hémodynamique sur la conduite de l'anesthésie.

We present the case of a 25-year-old woman with mitral valve disease and severe pulmonary hypertension scheduled for Caesarean section under general anaesthesia. General anaesthesia for such cardiac patients requires usually high doses of fentanyl prior to intubation, which favours maternal inhalation and neonatal ventilatory depression. Invasive haemodynamic monitoring allowed a rapid sequence induction, with an optimal drug titration and an early recovery.

[Areactive unilateral mydriasis after diagnostic celioscopy under general anesthesia]. / Mydriase unilatérale aréactive au décours d'une coelioscopie diagnostique sous anesthésie générale.

A unilateral areactive mydriasis occurred in a 49-year-old ASA I woman after a coelioscopic procedure while anaesthesia was maintained for an associated procedure. The various causes of brain stem damage were considered. The inability to perform a complete neurologic assessment resulted in the indication of a cerebral computerised tomography (CT) scan. The diagnosis of Adie's tonic pupil was made a posteriori, taking into consideration: 1) complete recovery without neurologic deficit; 2) unremarkable CT scan; 3) previous transient episodes of unilateral areactive mydriasis.