Labour CSE In A Patient With History Of Craniotomy And Intellectual Disability

Proposal Number:

MCC-7113 

Proposal Type:

Medically Challenging Case Report Poster 

Author:

Martin Velasquez  
SUNY Downstate

Co-Author:

Ivan Velickovic  
SUNY Downstate Medical Center

Abstract:

A 38 years old female presented at 39+2weeks gestational age for induction of labor. Past medical history significant for meningocephalitis and frontocentral craniotomy for hydrocephalus resulting in residual intellectual disability and epilepsy. Given normal neurologic examination a CSE was performed in the sitting position at level L4/L5. Due to limited ability to cooperate during the procedure a 25mg + 25mg IV ketamine was used pre-procedure. Spinal dose of 6mcg fentanyl and 3mg ropivicaine resulted in immediate pain relief. There were no significant hemodynamic changes. Continuous epidural infusion was set. Analgesia was adequate and delivery was successful. Catheter was removed 2 hours after delivery without complications.

Professional Category:

Resident/Trainee

Keywords:

Obstetric
Regional

Enter up to two references.

  Reference
1. Lisa R. Leffert, Lee H. Schwamm; Neuraxial Anesthesia in Parturients with Intracranial Pathology: A Comprehensive Review and Reassessment of Risk. Anesthesiology 2013;119(3):703-718. doi: 10.1097/ALN.0b013e31829374c2.