Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942011000400008
Brazilian Journal of Anesthesiology
Clinical Information

Anestesia para cesariana em paciente com siringomielia lombar

Anaesthesia for caesarean section in a patient with lumbar syringomyelia

Lakshmi Jayaraman; Nitin Sethi; Jayashree Sood

http://dx.doi.org/10.1590/S0034-70942011000400008 Braz J Anesthesiol, vol.61, n4, p.471-473, 2011
PDF Português
PDF English
Downloads: 0
Views: 765

Resumo

JUSTIFICATIVA E OBJETIVOS: Siringomielia é uma condição neurológica incomum caracterizada pela presença de uma cavidade cística expansiva na medula espinhal, resultando em várias manifestações neurológicas. O objetivo deste relato de caso é destacar a segurança da anestesia geral nesse grupo de pacientes. RELATO DO CASO: Primigesta de 28 anos, com diagnóstico de siringomielia lombar, foi programada para cirurgia de cesareana (CC). A cirurgia foi realizada sob anestesia geral, sem complicações. A anestesia geral foi escolhida no caso dessa paciente para evitar qualquer manipulação do espaço subaracnoideo no bloqueio do neuroeixo central, o que poderia levar a alterações da pressão intracraniana ou agravamento de sintomas neurológicos. Foi utilizado rocurônio, considerando que evita aumento de pressão no líquido cefalorraquidiano e hipercalemia, que podem ser vistos com succinilcolina. CONCLUSÕES: A anestesia geral pode ser usada com segurança em pacientes portadores de siringomielia. Devem-se tomar precauções para evitar aumento da pressão intracraniana e o bloqueio neuromuscular deve ser monitorado.

Palavras-chave

ANESTESIA, BLOQUEADOR MUSCULAR, CIRURGIA, DOENÇAS, DOENÇAS

Abstract

BACKGROUND AND OBJECTIVE: Syringomyelia is a rare neurological condition characterized by the presence of an expansive cystic cavity in the spinal cord, resulting in several neurologic manifestations. The objective of the present report was to address the safety of general anesthesia in this group of patients. CASE REPORT: This is a 28-year old primipara with lumbar syringomyelia scheduled for lower segment cesarean section (LSC). Surgery was performed under general anesthesia without complications. General anesthesia was chosen for this patient to avoid manipulation of the subarachnoid space during neuraxial anesthesia, which could cause changes in intracranial pressure or worsening neurological symptoms. We used rocuronium considering that it avoids rising in cerebrospinal fluid pressure and hyperkalemia that can be seen with succinylcholine. CONCLUSIONS: General anesthesia can be safely used in patients with syringomyelia. Care should be taken to prevent increase in intracranial pressure and neuromuscular blockade should be monitored.

Keywords

Syringomyelia, Anesthesia, Cesarean Section, Neuromuscular Nondepolarizing Agents

References

Madsen PW, Yezierski RP, Holets VR. Syringomyelia: clinical observations and experimental studies. J Neurotrauma. 1994;11:241-254.

Brewis M, Poskanzer DC, Rolland C. Neurological disease in an English city. Acta Neurol Scand. 1966;42(^ssupp):1-89.

Williams B. The distending force in the production of "communicating syringomyelia". Lancet. 1969;2:189-193.

Walton JN. Brain's Disease of the Nervous System. 1985:412-416.

Williams B. On the pathogenesis of syringomyelia: a review. J R Soc Med. 1980;73:798-806.

Nogues MA, Newman PK, Male VJ. Cardiovascular reflexes in syringomyelia. Brain. 1982;105:835-849.

McIlroy WJ, Richardson JC. Syringomyelia: a clinical review of 75 cases. Can Med Assoc J. 1965;93:731-734.

Semple DA, McClure JH, Wallace EM. Arnold-Chiari malformation in pregnancy. Anaesthesia. 1996;51:580-582.

Roelofse JA, Shipton EA, Nell AC. - Anaesthesia for caesarean section in a patient with syringomyelia: A case report. S Afr Med J. 1984;65:736-737.

Murayama K, Mamiya K, Nozaki K. Cesarean section in a patient with syringomyelia. Can J Anaest,h. 2001;48:474-477.

Nel MR, Robson V, Robinson PN. Extradural anaesthesia for caesarean section in a patient with syringomyelia and Chiari type I anomaly. Br J Anaesth. 1998;80:512-515.

5dd6bee80e8825a31a13f289 rba Articles
Links & Downloads
2352-2291 (Electronic) 0104-0014 (Printed)
Braz J Anesthesiol ©2024 All rights reserved.

Braz J Anesthesiol

Share this page
Page Sections