Spinal anesthesia for cesarean section in a patient with achondroplasia: case report

  • Lizette Benavides Department of Surgery, Universidad Industrial de Santander, Bucaramanga, Colombia.
  • Rubén Dario Heredia Department of Surgery, Universidad Industrial de Santander, Bucaramanga, Colombia.
  • Natalia Sauza Post-Anesthesia Care Unit, Hospital Universitario de Santander, Bucaramanga, Colombia.
  • Héctor Julio Meléndez-Flórez Department of Surgery, Universidad Industrial de Santander, Bucaramanga, Colombia.
Keywords: Anesthesia, Cesarean Section, Achondroplasia, Pregnant Women, Anesthesia Spinal

Abstract

Introduction:

The perioperative management of achondroplastic pregnant patients that will undergo lower segment cesarean section represents a clinical challenge to the anesthesiologist.

Objective:

To describe the anesthetic management of a pregnant patient with achondroplasia, programed for lower segment cesarean section using single-dose regional subarachnoid anesthesia, and to review the general guidelines for anesthetic management emphasizing the role of anesthesia in these patients.

Methods:

Case report and subject review.

Results:

The case of a first pregnancy in an achondroplastic, 117-cm tall patient and 38.5 weeks of gestation, programed for lower segment cesarean section is discussed. The patient received single-dose subarachnoid regional anesthesia and adjuvant opioids, with satisfactory results.

Conclusion:

The ideal anesthetic technique is controversial and the decision shall be based on the individual patient characteristics. The spinal technique, as the anesthetic approach to lower segment cesarean section, was satisfactory and safe in this particular patient.

References

1. Ornitz DM, Legeai-Mallet L. Achondroplasia: development, pathogenesis, and therapy. Dev Dyn 2017;246:291-309.

2. Osorio Rudas W, Socha García NI, Upegui A, et al. Anesthesia for cesarean section in a patient with achondroplasia. Rev Colomb Anestesiol 2012;40:309-312.

3. Richette P, Bardin T, Stheneur C. Achondroplasia: from genotype to phenotype. Joint Bone Spine 2008;75:125-130.

4. Dubiel L, Scott GA, Agaram R, et al. Achondroplasia: anaesthetic challenges for caesarean section. Int J Obstet Anesth 2014;23:274-278.

5. Chestnut DH, Wong CA, Tsen LC, et al. Musculoeskeletal disorders. Chestnut's obstetric anesthesia: principles and practice 5th ed.2014;Elsevier Saunders, Philadelphia:1093-1112.

6. Monedero P, Garcia-Pedrajas F, Coca I, et al. Is management of anesthesia in achondroplastic dwarfs really a challenge? J Clin Anesth 1997;9:208-212.

7. Inan G, Yayla E, Tas¸ Ü, et al. Single shot spinal anaesthesia for caesarean delivery of two achondroplasic parturients. Turk J Anaesthesiol Reanim 2015;43:285-287.

8. DeRenzo JS, Vallejo MC, Ramanathan S. Failed regional anesthesia with reduced spinal bupivacaine dosage in a parturient with achondroplasia presenting for urgent cesarean section. Int J Obstet Anesth 2005;14:175-178.

9. Li X, Duan H, Zuo M. Case report: anesthesia management for emergency cesarean section in a patient with dwarfism. BMC Anesthesiol 2015;15:59.

10. Nath S, Kapoor R, Saxena AK. Case report successful management of an achondroplastic dwarf for emergency caesarean section using intrathecal clonidine. J Anesth Crit Case Rep 2015;1:9-11.

11. Mitra S, Dey N, Gomber KK. Emergency cesarean section in a patient with achondroplasia: an anesthetic dilemma. J Anesth Clin Pharmacol 2007;23:315-318.

12. Samra T, Sharma S. Estimation of the dose of hyperbaric bupivacaine for spinal anaesthesia for emergency caesarean section in an achondroplastic dwarf. Indian J Anaesth 2010;54:481.

13. Lim SH, Shin C, Kim Y, et al. Epidural anesthetic management of achondroplastic parturient dwarf undergoing cesarean section. Anesth Pain Med 2012;7:181-184.

14. Ekwere IT, Edomwonyi NP, Imarengiaye CO. Anaesthetic challenges associated with achondroplasia: a case report. Afr JReprod Heal 2010;14:149-155.

15. Palomero MA, Vargas MC, Pelâez EM, et al. Spinal anaesthesia for emergency caesarean section in an achondroplastic patient. Eur J Anaesthesiol 2007;24:981-982.

16. Mikhael H, Vadivelu N, Braveman F. Safety of spinal anesthesia in a patient with achondroplasia for cesarean section. Curr Drug Saf 2011;6:130-131.

17. Marrón-Peña M, Mille-Loera JE. Therapeutic realities of the dural post- puncture headache. Rev Mex Anestesiol 2013;36:277-282.

18. Wight JM, Male D, Combeer A. Ultrasound-guided combined spinal-epidural anaesthesia for elective caesarean section in a patient with achondroplasia. Int J Obstet Anesth 2013;22:168-169.
How to Cite
1.
Benavides L, Heredia RD, Sauza N, Meléndez-Flórez HJ. Spinal anesthesia for cesarean section in a patient with achondroplasia: case report. Colomb. J. Anesthesiol. [Internet]. 2018 Oct. 1 [cited 2024 May 25];46(4):331-5. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/414

Downloads

Download data is not yet available.
Published
2018-10-01
How to Cite
1.
Benavides L, Heredia RD, Sauza N, Meléndez-Flórez HJ. Spinal anesthesia for cesarean section in a patient with achondroplasia: case report. Colomb. J. Anesthesiol. [Internet]. 2018 Oct. 1 [cited 2024 May 25];46(4):331-5. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/414
Section
Case Report / Case Series

Altmetric

Article metrics
Abstract views
Galley vies
PDF Views
HTML views
Other views
QR Code

Some similar items: