Failed regional anesthesia with reduced spinal bupivacaine dosage in a parturient with achondroplasia presenting for urgent cesarean section

A 36-year-old patient with a history of previous back surgery, asthma, latex allergy and achondroplasia presented for urgent cesarean delivery at 31 weeks’ gestation for worsening nonimmune fetal hydrops. The fetus was diagnosed with trisomy 21 and achondroplasia. Because of the urgent clinical situ...

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Bibliographic Details
Published in:International journal of obstetric anesthesia 2005-04, Vol.14 (2), p.175-178
Main Authors: DeRenzo, J.S., Vallejo, M.C., Ramanathan, S.
Format: Article
Language:English
Subjects:
Achondroplasia
Achondroplasia - physiopathology
Adult
Anesthesia, Epidural - methods
Anesthesia, Obstetrical - methods
Anesthesia, Spinal - methods
Bupivacaine - administration & dosage
Cesarean Section
Combined spinal epidural
Epidural
Female
General anesthesia
Humans
Pregnancy
Pregnancy Complications - physiopathology
Spinal
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Description
Summary:A 36-year-old patient with a history of previous back surgery, asthma, latex allergy and achondroplasia presented for urgent cesarean delivery at 31 weeks’ gestation for worsening nonimmune fetal hydrops. The fetus was diagnosed with trisomy 21 and achondroplasia. Because of the urgent clinical situation, the patient was given a spinal anesthetic, which required supplemental intravenous sedation after delivery of the fetus. This case report discusses the controversies in anesthetic management of this complicated patient and compromised fetus regarding general anesthesia, epidural, spinal and combined spinal-epidural anesthesia.
ISSN:0959-289X
1532-3374
DOI:10.1016/j.ijoa.2004.09.007