Anaesthesia for emergency caesarean section in a morbidly obese achondroplastic patient with PIH: Feasibility of Neuraxial anaesthesia?

Sharma, Ridhima; Magoon, Rohan; Choudhary, Ripon; Khanna, Poonam

doi:10.4103/0019-5049.198401

Cited by 4 publications

(3 citation statements)

References 5 publications

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“…These characteristic features contribute to increasing difficulty with neuraxial anesthesia. 7,8 In our patient, although she had mild lumbar lordosis with no neurological symptoms, there was difficulty in palpating her lumbar vertebral spaces. After checking intervertebral spaces using ultrasound, we initially attempted L3-4 for spinal anesthesia under real-time ultrasound guidance, but no cerebral spinal fluid was obtained.…”

Section: Discussionmentioning

confidence: 61%

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Real-time ultrasound-guided epidural anesthesia for cesarean section in a parturient with achondroplasia

2021

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Achondroplasia is a type of disproportionate dwarfism with short limbs and a normal-sized torso. This condition results in a potential spinal abnormality and a difficult airway may increase the anesthetic risk, not only in neuraxial anesthesia, but also in general anesthesia. We report a 25-year-old primigravida with achondroplasia who underwent cesarean section under epidural anesthesia with the assistance of real-time ultrasound guidance. A total dose of 17 mL 2% lidocaine with 7.5 μg sufentanil was administered via epidural catheter intermittently. The level of anesthesia reached T4. No other anesthetic was administered during the operation and the procedure was uneventful. The mother and her newborn were routinely discharged without any adverse events. During the follow-up at 10 months postoperatively, the patient did not have any discomfort. We suggest that titrated epidural anesthesia at the time of real-time ultrasound-guidance is a safe and effective epidural anesthesia for patients with achondroplasia.

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Section: Discussionmentioning

confidence: 61%

“…found that the dose of spinal anesthesia in a patient with morbid obesity and achondroplasia was 50% that of normal. 8 A titrated epidural anesthetic dose has been proven to be safe. 20 In the present case, the total dose of epidural anesthetic was 17 mL, which was not less than that for a normal parturient.…”

Section: Discussionmentioning

confidence: 99%

Real-time ultrasound-guided epidural anesthesia for cesarean section in a parturient with achondroplasia

2021

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“…After the antigens are identified by the maternal immune system, no rejection is produced, and a protective immune response is active until the foetus is delivered [9]. Since foetal delivery depends on the maternal body's own immune balance, PIH itself may be caused by immune system imbalance of the body [10]. Recent studies support this hypothesis.…”

Section: Introductionmentioning

confidence: 99%