Anaesthesia for an emergent caesarean section in a patient with acute transverse myelitis
We present a 32-year-old G1P0 woman at 32 weeks and two days gestation with new onset paraplegia, hyperreflexia, and sensory disturbance that gradually progressed over the past month and acutely worsened over the last 24 hours. MRI revealed a demyelinating process of the thoracic spine and diffuse c...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2018-01-01
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| Series: | Journal of Obstetric Anaesthesia and Critical Care |
| Subjects: | |
| Online Access: | http://www.joacc.com/article.asp?issn=2249-4472;year=2018;volume=8;issue=1;spage=58;epage=59;aulast=Hunter |
| _version_ | 1811256874875486208 |
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| author | Samuel A Hunter Daniel Katz Kyle J Riley Michael Anderson |
| author_facet | Samuel A Hunter Daniel Katz Kyle J Riley Michael Anderson |
| author_sort | Samuel A Hunter |
| collection | DOAJ |
| description | We present a 32-year-old G1P0 woman at 32 weeks and two days gestation with new onset paraplegia, hyperreflexia, and sensory disturbance that gradually progressed over the past month and acutely worsened over the last 24 hours. MRI revealed a demyelinating process of the thoracic spine and diffuse cervicothoracic cord oedema. After 7 days, her foetus developed recurrent heart rate decelerations and an emergent caesarean section was performed. On airway exam, she was Mallampati 3 with a short thyromental distance. She reported fasting overnight and into the morning. Our choice was between performing neuraxial anaesthesia in the setting of an acute demyelinating process of her spinal cord versus general anaesthesia on a patient at risk of aspiration with a potentially difficult airway. Given the potential complications of neuraxial anaesthesia, we utilized rocuronium to perform a rapid sequence induction of general anaesthesia with endotracheal intubation. |
| first_indexed | 2024-04-12T17:47:54Z |
| format | Article |
| id | doaj.art-32513543068d44f8b9eadc03f8c25190 |
| institution | Directory Open Access Journal |
| issn | 2249-4472 |
| language | English |
| last_indexed | 2024-04-12T17:47:54Z |
| publishDate | 2018-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Obstetric Anaesthesia and Critical Care |
| spelling | doaj.art-32513543068d44f8b9eadc03f8c251902022-12-22T03:22:35ZengWolters Kluwer Medknow PublicationsJournal of Obstetric Anaesthesia and Critical Care2249-44722018-01-0181585910.4103/joacc.JOACC_45_17Anaesthesia for an emergent caesarean section in a patient with acute transverse myelitisSamuel A HunterDaniel KatzKyle J RileyMichael AndersonWe present a 32-year-old G1P0 woman at 32 weeks and two days gestation with new onset paraplegia, hyperreflexia, and sensory disturbance that gradually progressed over the past month and acutely worsened over the last 24 hours. MRI revealed a demyelinating process of the thoracic spine and diffuse cervicothoracic cord oedema. After 7 days, her foetus developed recurrent heart rate decelerations and an emergent caesarean section was performed. On airway exam, she was Mallampati 3 with a short thyromental distance. She reported fasting overnight and into the morning. Our choice was between performing neuraxial anaesthesia in the setting of an acute demyelinating process of her spinal cord versus general anaesthesia on a patient at risk of aspiration with a potentially difficult airway. Given the potential complications of neuraxial anaesthesia, we utilized rocuronium to perform a rapid sequence induction of general anaesthesia with endotracheal intubation.http://www.joacc.com/article.asp?issn=2249-4472;year=2018;volume=8;issue=1;spage=58;epage=59;aulast=HunterAcute transverse myelitisemergent caesarean sectiongeneral anaesthesia with endotracheal intubationneuraxial anaesthesia |
| spellingShingle | Samuel A Hunter Daniel Katz Kyle J Riley Michael Anderson Anaesthesia for an emergent caesarean section in a patient with acute transverse myelitis Journal of Obstetric Anaesthesia and Critical Care Acute transverse myelitis emergent caesarean section general anaesthesia with endotracheal intubation neuraxial anaesthesia |
| title | Anaesthesia for an emergent caesarean section in a patient with acute transverse myelitis |
| title_full | Anaesthesia for an emergent caesarean section in a patient with acute transverse myelitis |
| title_fullStr | Anaesthesia for an emergent caesarean section in a patient with acute transverse myelitis |
| title_full_unstemmed | Anaesthesia for an emergent caesarean section in a patient with acute transverse myelitis |
| title_short | Anaesthesia for an emergent caesarean section in a patient with acute transverse myelitis |
| title_sort | anaesthesia for an emergent caesarean section in a patient with acute transverse myelitis |
| topic | Acute transverse myelitis emergent caesarean section general anaesthesia with endotracheal intubation neuraxial anaesthesia |
| url | http://www.joacc.com/article.asp?issn=2249-4472;year=2018;volume=8;issue=1;spage=58;epage=59;aulast=Hunter |
| work_keys_str_mv | AT samuelahunter anaesthesiaforanemergentcaesareansectioninapatientwithacutetransversemyelitis AT danielkatz anaesthesiaforanemergentcaesareansectioninapatientwithacutetransversemyelitis AT kylejriley anaesthesiaforanemergentcaesareansectioninapatientwithacutetransversemyelitis AT michaelanderson anaesthesiaforanemergentcaesareansectioninapatientwithacutetransversemyelitis |