Key points for anesthetic and hemodynamic management during labor and delivery in aortic aneurysm (Marfan syndrome)

Hemodynamic goals	Avoid	Monitor	Intervention
Reduce afterload	Hypertension and aortic wall stress	Intra-arterial blood pressure	Minimize aortic wall stress with: Beta blockade (esmolol or labetalol) Vasodilators (nitroglycerin or nicardipine) if necessary Effective analgesia to minimize or eliminate pain Adequate doses of anesthetic agents to block sympathetic responses if general anesthesia is necessary

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