Emergenc Y Caesarian Section in a Patient With Achondroplasia : A Case Report

Abstract

ABSTRACT:The word Achondroplasia literally means "Without Cartilage Formation". It results from abnormal cartilage formation at epiphyseal growth plates. It is the most common form of short limbed dwarfism. Since it is a congenital short statured disease patient can have respiratory, neurological and cardiac problems associated with and poses many challenges to anaesthesiologists to choose best anaesthetic choice. CASE REPORT: A 27 years old parturient with short stature (3 feet 8 inches) weighing 45.5 Kgs came to the hospital in early labor with 37 weeks of gestation. Patient presenting cephalopelvic disproportion and foetal distress. She had mild lumbar lordosis and very mild scoliosis and the patient known hypothyroid since the beginning of the pregnancy and on treatment. There is no previous history of exposure to anaesthesia and no previous surgical history. Family history reveals, no person in the family has got Achondroplasia. We used low dose Bupivacaine 1.2ml (6mg) along with fentanyl 0.2ml of fentanyl (10 micrograms) for spinal anaesthesia. First attempt was a dry tap followed a successful spinal anaesthesia with adequate block achieved. CONCLUSION: In spite of not many case reports of spinal anaesthesia in Achondroplasia, spinal anaesthesia remains an appropriate option in emergency caesarian section.