Anaesthetic management of an obstetric patient with idiopathic acute transverse myelitis

• Published in: International journal of obstetric anesthesia Vol. 19; no. 1; pp. 98 - 101
• Main Authors: Walsh, P, Grange, C, Beale, N
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-01-2010
• Subjects: Acute Disease; Adult; Anaesthesia; Anesthesia & Perioperative Care; Anesthesia, Obstetrical; Autonomic dysreflexia; Caesarean section; Cesarean Section; Depressive Disorder, Major - complications; Female; Gait Disorders, Neurologic - etiology; Humans; Infant, Newborn; Magnetic Resonance Imaging; Myelitis, Transverse - complications; Neuromuscular Depolarizing Agents; Obstetrics and Gynecology; Pain - complications; Pain, Postoperative - drug therapy; Pregnancy; Succinylcholine; Transverse myelitis; Anaesthesia; Autonomic dysreflexia; Caesarean section; Transverse myelitis
• ISSN: 0959-289X; 1532-3374
• DOI: 10.1016/j.ijoa.2009.04.008

Abstract Idiopathic acute transverse myelitis is a rare focal inflammatory disorder of the spinal cord causing motor, sensory and autonomic dysfunction. We report the successful use of general anaesthesia for caesarean section in a patient with this disease. Potential anaesthetic concerns include autonomic dysreflexia and hyperkalaemia following the use of suxamethonium. Further complicating issues with this patient included psychotic depression and new-onset neuropathic pain on a background of chronic pain symptoms.