Successful Epidural Labor Analgesia In A Patient With Neurofibromatosis Type 1

Proposal Number:

MCC-7117 

Proposal Type:

Medically Challenging Case Report Poster 

Author:

Cole Laber  
Mayo Clinic

Co-Author(s):

Brittney Clark  
Mayo Clinic
Hans Sviggum  
Mayo Clinic

Abstract:

A 20 yo G2P0 at 37 presented for labor induction for cholestasis. PMH was significant for Neurofibromatosis Type 1 with an extensive cervical plexus infiltrating lesion, asymmetric quadriparesis and C2-C4 fusion with kyphoscoliosis and limited neck mobility. She was taking enoxaparin for Factor V Leiden, but had no administration for >24 hours. MRI showed no lumbar neurofibromas. After assessing risks and benefits of neuraxial anesthesia in the setting of potentially difficult airway and existing neurologic deficits, she elected to receive epidural analgesia. A lumbar epidural was placed with administration of bupivacaine & fentanyl and PIEB boluses with PCEA available. She had NSVD and subsequent uncomplicated postoperative course.

Professional Category:

Resident/Trainee

Keywords:

Obstetric

Supporting Image: NeurofibromaCervical.PNG
   ·Cervical Neurofibroma
Supporting Image: MRICervical.png
   ·Cervical Spine MRI
 

Enter up to two references.

  Reference
1. F. T. Mendonça, et. Al. Anesthetic Management in Patient with Neurofibromatosis: A Case Report and Literature Review. Acta Anaesthe. Belg. 2016, 67, 48-52
2. Esler MD, Durbridge J, Kirby S. Epidural haematoma after dural puncture in a parturient with neurofibromatosis. Br J Anaesth. 2001 Dec;87(6):932-4.