Epidural analgesia for labour in a patient with a neural tube defect

• Published in: Anaesthesia and intensive care Vol. 34; no. 6; pp. 816 - 819
• Main Authors: ALTAMIMI, Y, PAVY, T. J. G
• Format: Journal Article
• Language: English
• Published: Edgecliff Anaesthesia and Intensive Care 01.12.2006; Sage Publications Ltd. (UK); Sage Publications Ltd
• Subjects: Adult; Analgesia, Epidural - methods; Analgesia, Epidural - standards; Analgesia, Obstetrical - methods; Analgesia, Obstetrical - standards; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Female; Humans; Informed Consent; Labor, Obstetric; Medical sciences; Pregnancy; Pregnancy Complications - diagnostic imaging; Radiography; Spina Bifida Cystica - complications; Spina Bifida Cystica - diagnostic imaging; Human; spinal dysraphism; Nervous system diseases; Diseases of the osteoarticular system; epidural analgesia; obstetric analgesia; Spine disease; Congenital disease; Obstetrics; Neural tube defect; Extradural; Analgesia; Spina bifida; Malformation; Anesthesia
• ISSN: 0310-057X; 1448-0271
• DOI: 10.1177/0310057x0603400609

This report describes the use of epidural analgesia in a patient with a known neural tube defect. The patient had a severe form of spina bifida cystica which had been operated on in childhood. She had a neurogenic bladder but otherwise had preserved neurological function. She had an epidural catheter inserted in early labour; providing effective analgesia for an uneventful birth. This case outlines the severity of the cystica category of neural tube defects, the added anatomical challenges of previous surgery and the difficulties that may arise from the utilization of epidural analgesia. The case demonstrates that epidural analgesia can be utilized despite such a disorder A thorough history and examination are essential, as are the patient's informed consent and knowledge of possible complications.