Neuraxial anesthesia for a laboring patient with hereditary spastic paraplegia: A case report

IF 0.2 Q4 ANESTHESIOLOGY
Joshua Falescky, M. Gerasimov, J. Aronsohn, G. Palleschi
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引用次数: 0

Abstract

Hereditary spastic paraplegia (HSP) is a rare, inherited condition affecting the corticospinal tract, typically characterized by bilateral lower extremity weakness and stiffness. HSP presents challenges to anesthetic management, particularly in the obstetric population due to the paucity of existing recommendations in the literature. Although case reports exist regarding the successful use of general and neuraxial anesthesia for cesarean section, none currently exist with regard to labor analgesia. Here, we report the use of labor epidural anesthesia in a 29-year-old woman with HSP. She delivered via cesarean delivery after laboring for 27 h with an epidural catheter in place. The patient tolerated epidural placement well with no adverse neurologic sequelae. The utilization of neuraxial techniques avoids the risks associated with airway manipulation in a parturient and obviates the need for the use of muscle relaxants in the setting of upper motor neuron disease. Epidural anesthesia appears to be a safe approach to the management of labor and cesarean delivery in a parturient with HSP.
神经轴麻醉治疗遗传性痉挛性截瘫1例
遗传性痉挛性截瘫(HSP)是一种罕见的影响皮质脊髓束的遗传性疾病,通常以双侧下肢无力和僵硬为特征。HSP对麻醉管理提出了挑战,尤其是在产科人群中,因为文献中缺乏现有的建议。尽管有关于成功使用全身麻醉和神经轴麻醉进行剖宫产的病例报告,但目前还没有关于分娩镇痛的病例报告。在此,我们报告了一名29岁的HSP妇女使用硬膜外分娩麻醉的情况。在硬膜外导管到位的情况下分娩27小时后,她通过剖宫产分娩。患者对硬膜外麻醉的耐受性良好,无不良神经后遗症。神经轴技术的使用避免了与产妇气道操作相关的风险,并避免了在上运动神经元疾病的情况下使用肌肉松弛剂的需要。硬膜外麻醉似乎是HSP产妇分娩和剖宫产的一种安全方法。
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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37
审稿时长
29 weeks
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