Anesthetic management for Cesarean delivery in parturients with a diagnosis of dwarfism
PURPOSE: The literature on the anesthetic management of parturients with dwarfism is sparse and limited to isolated case reports. Pregnancy complications associated with dwarfism include an increased risk of respiratory compromise, an increased risk of Cesarean delivery, and an unpredictable degree of anesthesia with neuraxial techniques. Therefore, we conducted this retrospective review to evaluate the anesthetic management of parturients with a diagnosis of dwarfism.
METHODS: We used a query of billing data to identify short statured women who underwent a Cesarean delivery during May 1, 2008 to May 1, 2013. We then hand searched the electronic medical record for qualifying patients with heights < 148 cm and a diagnosis of dwarfism. The extracted data included patient demographics and obstetric and anesthetic information.
RESULTS: We identified 13 women with dwarfism who had 15 Cesarean deliveries in total. Twelve of the women had disproportionate dwarfism, and ten of the 15 Cesarean deliveries were due to cephalopelvic disproportion. Neuraxial anesthesia was attempted in 93% of deliveries. The dose chosen for initiation of neuraxial anesthesia was lower than the typical doses used in parturients of normal stature. Neuraxial anesthetic complications included difficult neuraxial placement (64%), high spinal (7%), inadequate surgical level (13%), and unrecognized intrathecal catheter (7%).
CONCLUSIONS: The data collected suggest that females with a diagnosis of dwarfism may have difficult neuraxial placement and potentially require lower dosages of local anesthetic for both spinal and epidural anesthesia to achieve adequate surgical blockade.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2016 |
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| Erschienen: |
2016 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:63 |
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| Enthalten in: |
Canadian journal of anaesthesia = Journal canadien d'anesthesie - 63(2016), 8 vom: 21. Aug., Seite 945-51 |
| Sprache: |
Englisch |
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| Weiterer Titel: |
Prise en charge anesthésique d'un accouchement par césarienne chez des parturientes ayant un diagnostic de nanisme |
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| Beteiligte Personen: |
Lange, Elizabeth M S [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 31.03.2017 Date Revised 17.08.2017 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s12630-016-0671-5 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM260301795 |
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| 245 | 1 | 0 | |a Anesthetic management for Cesarean delivery in parturients with a diagnosis of dwarfism |
| 246 | 3 | 3 | |a Prise en charge anesthésique d'un accouchement par césarienne chez des parturientes ayant un diagnostic de nanisme |
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| 500 | |a Date Revised 17.08.2017 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a PURPOSE: The literature on the anesthetic management of parturients with dwarfism is sparse and limited to isolated case reports. Pregnancy complications associated with dwarfism include an increased risk of respiratory compromise, an increased risk of Cesarean delivery, and an unpredictable degree of anesthesia with neuraxial techniques. Therefore, we conducted this retrospective review to evaluate the anesthetic management of parturients with a diagnosis of dwarfism | ||
| 520 | |a METHODS: We used a query of billing data to identify short statured women who underwent a Cesarean delivery during May 1, 2008 to May 1, 2013. We then hand searched the electronic medical record for qualifying patients with heights < 148 cm and a diagnosis of dwarfism. The extracted data included patient demographics and obstetric and anesthetic information | ||
| 520 | |a RESULTS: We identified 13 women with dwarfism who had 15 Cesarean deliveries in total. Twelve of the women had disproportionate dwarfism, and ten of the 15 Cesarean deliveries were due to cephalopelvic disproportion. Neuraxial anesthesia was attempted in 93% of deliveries. The dose chosen for initiation of neuraxial anesthesia was lower than the typical doses used in parturients of normal stature. Neuraxial anesthetic complications included difficult neuraxial placement (64%), high spinal (7%), inadequate surgical level (13%), and unrecognized intrathecal catheter (7%) | ||
| 520 | |a CONCLUSIONS: The data collected suggest that females with a diagnosis of dwarfism may have difficult neuraxial placement and potentially require lower dosages of local anesthetic for both spinal and epidural anesthesia to achieve adequate surgical blockade | ||
| 650 | 4 | |a Journal Article | |
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| 700 | 1 | |a Stariha, Jillian |e verfasserin |4 aut | |
| 700 | 1 | |a Nixon, Heather C |e verfasserin |4 aut | |
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