High dose alfentanil as sole anaesthetic induction agent for caesarean section in a patient with severe ischaemic heart disease

A 43-year-old woman presented at 34 weeks' gestation with pre-eclampsia and intra-uterine growth restriction. She had a past medical history of myocar dial infarction and had angina, on moderate effort. She also had non-insuli n dependent diabetes mellitus, chronic obstructive airways disease and hype r-cholesterolaemia, The onset of unstable angina, cardiac failure and a det eriorating fetal condition necessitated urgent delivery by caesarean sectio n. General anaesthesia was chosen. High dose alfentanil was used as sole in duction agent resulting in minimal haemodynamic change and a successful mat ernal and fetal outcome. (C) 2000 Harcourt Publishers Ltd.