Anesthetic management of cesarean section in a patient with Léri-Weill dyschondrosteosis – A case report

IF 0.2 Q4 ANESTHESIOLOGY
Muizz Hussain, Nikhil Nair, Matthew Foss, James Paul
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引用次数: 0

Abstract

When providing spinal anesthesia for patients with achondroplasia, a dose reduction is often recommended to prevent respiratory arrest and total spinal blocks as patients with achondroplasia present with spinal complications such as spinal cord stenosis, kyphoscoliosis, and lumbar lordosis. This case report describes why this dose reduction is unnecessary in patients with Léri–Weill dyschondrosteosis (LWD) dwarfism and how a regular spinal neuraxial approach is safe and efficacious. A 38-year-old pregnant woman with physical findings consistent with LWD and unremarkable past medical history presented for a repeat elective cesarean section. On examination, the patient was noted to have conserved spinal length and anatomy. In accordance with current recommendations, this patient received a 20% reduced spinal anesthetic dose for her cesarean section based on her height. The cesarean was uneventful. Additional dose reduction was found to be unnecessary due to normal spinal length and anatomy. This characteristic of LWD warrants a review of the clinical recommendations surrounding the anesthetic management of patients with LWD.
Léri Weill软骨发育不全症患者剖宫产的麻醉处理——一例报告
当为软骨发育不全患者提供脊柱麻醉时,通常建议减少剂量,以防止呼吸停止和完全脊柱阻滞,因为软骨发育不全病患者会出现脊髓狭窄、后凸和腰椎前凸等脊柱并发症。本病例报告描述了为什么在Léri–Weill软骨发育不良症(LWD)侏儒症患者中不需要减少剂量,以及常规脊髓-神经轴入路是如何安全有效的。一名38岁的孕妇,其身体检查结果与LWD一致,既往病史不明显,建议再次进行选择性剖宫产。在检查中,患者注意到脊柱长度和解剖结构是保守的。根据目前的建议,该患者在剖宫产时根据身高减少了20%的脊椎麻醉剂量。剖宫产手术平安无事。由于脊柱长度和解剖结构正常,额外的剂量减少被发现是不必要的。LWD的这一特点值得对LWD患者麻醉管理的临床建议进行审查。
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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审稿时长
29 weeks
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