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Combined Spinal-Epidural Analgesia for Laboring Parturient with Arnold-Chiari Type I Malformation: A Case Report and a Review of the Literature
Combined Spinal-Epidural Analgesia for Laboring Parturient with Arnold-Chiari Type I Malformation: A Case Report and a Review of the Literature
- Source :
- Case Reports in Anesthesiology, Case Reports in Anesthesiology, Vol 2013 (2013)
- Publication Year :
- 2013
- Publisher :
- Hindawi Limited, 2013.
-
Abstract
- Anesthetic management of laboring parturients with Arnold-Chiari type I malformation poses a difficult challenge for the anesthesiologist. The increase in intracranial pressure during uterine contractions, coughing, valsalva maneuvers, and expulsion of the fetus can be detrimental to the mother during the process of labor and delivery. No concrete evidence has implicated high cerebral spinal fluid pressure on maternal and fetal complications. The literature on the use of neuraxial techniques for managing parturients with Arnold-Chiari is extremely scarce. While most anesthesiologists advocate epidural analgesia for management of labor pain and spinal anesthesia for cesarean section, we are the first to report the use of combined spinal-epidural analgesia for managing labor pain in a pregnant woman with Arnold-Chiari type I malformation. Also, we have reviewed the literature and presented information from case reports and case series to support the safe usage of neuraxial techniques in these patients.
- Subjects :
- Cerebral Spinal Fluid
business.industry
Anesthetic management
Spinal anesthesia
Case Report
Labor pain
lcsh:RD78.3-87.3
Anesthesiology and Pain Medicine
Combined spinal epidural
lcsh:Anesthesiology
Anesthesia
Medicine
Arnold-Chiari type I malformation
business
reproductive and urinary physiology
Intracranial pressure
Subjects
Details
- ISSN :
- 20906390 and 20906382
- Volume :
- 2013
- Database :
- OpenAIRE
- Journal :
- Case Reports in Anesthesiology
- Accession number :
- edsair.doi.dedup.....fd07a3b7ddc86b4d1f79347cd71dac98
- Full Text :
- https://doi.org/10.1155/2013/512915