Epidural analgesia in labour for a patient with hereditary neuropathy with liability to pressure palsy.
Hereditary neuropathy with liability to pressure palsy (HNPP) is a rare but probably under-diagnosed disorder of peripheral nerves in which individuals suffer from repeated motor and sensory neuropathies (pressure palsies) following brief nerve compression or mild trauma. A seemingly trivial insult such as sitting or kneeling may result in a focal neurological deficit lasting for hours to months. Despite the growing recognition of this problem, information regarding the anaesthetic management of labour is sparse. We present a woman with HNPP who was provided with a modified epidural regimen (low concentration bupivacaine and fentanyl) for analgesia in labour and delivery. Labour progressed uneventfully and there were no neurological sequelae following delivery.
Department of Anaesthesia, Northern General Hospital, Sheffield, UK.
G R
GR
Lepski
J D
JD
Alderson