Periduralanästhesie mit Ropivacain bei Friedreich-Ataxie

Abstract

Friedreich's ataxia (FA) is a hereditary disease, which leads to degenerative changes in the spinal cord and cerebellum (incidence 1:50,000). These changes are caused by a defect in the gene that encodes a mitochondrial gene called frataxin and causes muscle weakness, scoliosis, cardiomyopathy and impaired glucose tolerance. Therefore, these patients require special care during anaesthesia. We report the case of a 25-year-old primigravida with a history of FA and dorsal stabilisation of the vertebral column, who was admitted to our hospital for elective caesarean section. Due to increased sensitivity to muscle relaxants, peridural anaesthesia with 8 ml 0.75% ropivacaine and 10 microg sufentanil was used in this case. The perioperative neurological consultation revealed no undue exacerbation of symptoms.

Anaesthesia for a patient with Friedreich′s ataxia

“…[4] Central neuraxial blockade has been safely used as an anaesthetic technique in patients with Friedreich's ataxia for various procedures as per the literature available. [5–6] However, it was not chosen as the technique of choice in this patient fearing worsening of neurological symptoms and medicolegal issues. Similarly, general anaesthesia using various non-depolarising muscle relaxants and volatile anaesthetics were used with normal or near normal responses, though earlier reports showed sensitivity to some of these agents.…”