A successful combined spinal-epidural anesthesia for cesarean section in a patient with neurofibromatosis type 1-associated dural ectasia.

IF 0.8 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2024-10-01 DOI:10.1186/s40981-024-00745-w

Hitomi Taka, Nobuyoshi Kusama, Minami Sakamoto, Nobuko Sasano, Motoshi Tanaka

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引用次数: 0

Abstract

Background: Dural ectasia is a common manifestation of neurofibromatosis type 1. Although there have been reports of unsuccessful spinal anesthesia due to dual ectasia in Marfan syndrome, reports describing similar unsuccessful spinal anesthesia in neurofibromatosis type 1 are lacking.

Case presentation: A parturient with neurofibromatosis type 1 was scheduled for a repeat cesarean section. During a previous cesarean section, she had experienced a failed spinal anesthesia, which resulted in a conversion to general anesthesia. Preoperative lumbar magnetic resonance imaging revealed dural ectasia, which was speculated to be the cause of the previous spinal anesthesia failure. Therefore, combined spinal-epidural anesthesia was implemented. Because the block level of spinal anesthesia was insufficient as predicted, supplemental administration of epidural anesthesia successfully provided adequate analgesia for the surgery.

Conclusions: Combined spinal-epidural anesthesia can be useful for the management of cesarean sections in patients with neurofibromatosis type 1-associated dural ectasia.

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为一名患有神经纤维瘤病 1 型相关硬膜异位症的患者成功实施了脊髓-硬膜外联合麻醉剖腹产手术。

背景：硬脊膜异位症是神经纤维瘤病 1 型的常见表现。虽然曾有报道称马凡综合征患者因双硬膜异位而导致脊柱麻醉失败，但目前还缺乏 1 型神经纤维瘤病患者脊柱麻醉失败的类似报道：一名患有神经纤维瘤病 1 型的产妇计划再次进行剖腹产手术。在前一次剖宫产手术中，她经历了一次失败的脊髓麻醉，结果转为全身麻醉。术前腰椎磁共振成像显示硬膜异位，推测这是之前脊髓麻醉失败的原因。因此实施了脊髓-硬膜外联合麻醉。由于脊髓麻醉的阻滞水平不如预期，补充硬膜外麻醉成功地为手术提供了充分的镇痛：结论：脊髓-硬膜外联合麻醉可用于神经纤维瘤病1型相关硬膜外症患者的剖宫产手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.