Anesthesia for cesarean section in a patient with paraplegia resulting from tumour metastases to spinal cord

Jones, Brian Christopher; Milliken, Brock C.; Penning, Donald H.

doi:10.1007/bf03027967

Cited by 8 publications

(2 citation statements)

References 24 publications

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“…In the case of a Caesarean section, a rapid sequence induction will be necessary but succinylcholine is contraindicated because of an increased risk of hyperkalaemia. Alternatively, high‐dose non‐depolarising muscle relaxants or fibreoptic awake intubation may be used 10 …”

Section: Spinal Cord Injury/para‐ and Quadriplegiamentioning

confidence: 99%

Neuraxial techniques in patients with pre‐existing back impairment or prior spine interventions: a topical review with special reference to obstetrics

Vercauteren

Waets

Pitkänen

et al. 2011

Acta Anaesthesiol Scand

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Many anaesthetists consider neurological disorders of all kinds as a contraindication for regional anaesthesia particularly for neuraxial techniques. This hesitation is partly rooted in fears of medicolegal problems but also in the heterogeneous literature. Therefore, the present topical review is an attempt to describe the feasibility and the risks of neuraxial techniques in patients with spinal injury, anatomical compromise, chronic back pain or previous spinal interventions, ranging from 'minor' types like epidural blood patches to major surgery such as Harrington fusions. Most reviews and case reports were describing experiences in obstetrics as these patients are more likely to insist on neuraxial blocks. In the acute phase of new neurologic injury, general anaesthesia may be the technique of choice to prevent further haemodynamic and respiratory deterioration. After the acute phase, current evidence is mostly reassuring with respect to the risks of neuraxial blocks as they may even be recommendable in some conditions. Ultrasound technology may be of additional help to increase the success rate. A careful pre-operative examination remains mandatory, while patients should be sufficiently informed about technical aspects and possible relapses or progression of their disease. When necessary, patients should have additional technical and clinical examinations as close as possible to surgery to establish the actual pre-operative status. Most patients may benefit more from spinal techniques rather than from less reliable epidural ones. High concentrations and volumes of local anaesthetics should be avoided at all times, especially in patients with nerve compression, large disc herniation or spinal stenosis.

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Section: Spinal Cord Injury/para‐ and Quadriplegiamentioning

confidence: 99%

Neuraxial techniques in patients with pre‐existing back impairment or prior spine interventions: a topical review with special reference to obstetrics

Vercauteren

Waets

Pitkänen

et al. 2011

Acta Anaesthesiol Scand

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“…In women with paraplegia, AHR may occur during cesarean sections either by general or regional anesthesia, and analgesic insufficiency is a strong inducing factor in AHR ( 5 ). The impact of introducing various methods of anesthesia on patients with paraplegia and SCI has been investigated in previous studies, including the general anesthesia ( 6 – 8 ), epidural anesthesia ( 4 , 9 ), spinal anesthesia ( 1 , 5 , 10 ), transversus abdominis plane block ( 11 ), and even no anesthesia ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Anesthetic Management of Cesarean Section in a Patient With Paraplegia

Su¹,

Lei²,

Yu³

2022

Front. Med.

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BackgroundWith the advancement of medical science and rehabilitative care, more women with spinal cord injury (SCI) can conceive. However, autonomic hyperreflexia due to SCI complicates anesthesia management during cesarean sections.Case PresentationThis study reports the anesthesia management in a woman with paraplegia with a T6 SCI lesion who underwent a cesarean section. It also reviews the anesthesia strategies used in other studies. Spinal anesthesia with a low concentration of ropivacaine was administered along with dexmedetomidine for sedation. Stable hemodynamics were achieved without complications.ConclusionsBased on the reported case and literature review, we conclude that the intrathecal block is the preferred choice for women with paraplegia who require cesarean section if the lumbar bone structure allows puncture attempts.

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Spinal anaesthesia for caesarean section in the presence of respiratory failure and spinal metastases from a soft tissue clear cell sarcoma

Mišković

Dob

2013

International Journal of Obstetric Anesthesia

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Anesthesia for cesarean section in a patient with paraplegia resulting from tumour metastases to spinal cord

Cited by 8 publications

References 24 publications

Neuraxial techniques in patients with pre‐existing back impairment or prior spine interventions: a topical review with special reference to obstetrics

Neuraxial techniques in patients with pre‐existing back impairment or prior spine interventions: a topical review with special reference to obstetrics

Case Report: Anesthetic Management of Cesarean Section in a Patient With Paraplegia

Spinal anaesthesia for caesarean section in the presence of respiratory failure and spinal metastases from a soft tissue clear cell sarcoma

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