Epidural anaesthesia for caesarean section in a patient with quadriplegia and autonomic hyperreflexia.
The anaesthetic management of a pregnant quadriplegic woman with a history of autonomic hyperreflexia is discussed. Autonomic hyperreflexia is a life-threatening complication of high spinal cord transection, for which labour is a well known stimulus. It can lead to uncontrolled hypertension. We discuss the anaesthetic considerations in planning the care of this patient, who was managed for elective caesarean section and post partum hypertension with epidural anaesthesia.
Burns
R
R
Department of Anaesthesia, Critical Care and Pain Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK. rosburnsgraham@aol.com
Clark
V A
VA
D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D020211:Autonomic Dysreflexia / Q000150:complications*; D002585:Cesarean Section; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy; D006801:Humans; D006973:Hypertension / Q000517:prevention & control; D016343:Monitoring, Intraoperative; D011247:Pregnancy; D011782:Quadriplegia / Q000150:complications*