1/2. Anaesthetic management of caesarean section for a mother with pre-eclampsia, the klippel-feil syndrome and congenital hydrocephalus.A mother with the klippel-feil syndrome, congenital hydrocephalus and increased intracranial pressure presented for delivery by Caesarean section at 33 weeks because of pre-eclampsia. Anaesthetic management comprised awake intubation using the fibreoptic bronchoscope, followed by induction and maintenance of general anaesthesia for the delivery of a live male infant. This case report describes the problems arising under these circumstances and the relative merits of different anaesthetic techniques.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/2. Anaesthesia for caesarean section in a patient with klippel-feil syndrome. The use of a microspinal catheter.A 34-year-old woman with severe kyphoscoliosis, an immobile cervical spine, and short stature due to the klippel-feil syndrome presented for elective Caesarean section. She expressed a strong desire to remain awake during the procedure. We chose a technique using a spinal microcatheter to provide spinal anaesthesia on the basis that incremental control of the dose of bupivacaine would reduce the risk of 'high' block. Awake inspection of the larynx was performed as a precaution in the event of respiratory embarrassment. A total of 6.25 mg heavy bupivacaine, 7.5 mg plain bupivacaine, and 10 micrograms fentanyl were administered over 20 min. This provided anaesthesia up to T5 without significant effects on respiratory or cardiovascular function. The patient was successfully delivered of a healthy boy.- - - - - - - - - - ranking = 2keywords = anaesthesia (Clic here for more details about this article) |