Anesthetic management of an obstetric patient with Charcot-Marie-Tooth disease: a case study.
Additional documentation of regional anesthesia in patients with Charcot-Marie-Tooth disease (CMT) is needed to guide practitioners and patients in exploring appropriate options for anesthesia and analgesia management. This case report describes the successful use of a combined spinal-epidural technique for labor progressing to cesarean delivery in a patient with CMT. Previous similar case reports were reviewed and an extensive literature search was conducted to organize the limited body of research regarding use of regional anesthesia in patients with CMT. Opinions regarding regional anesthesia in patients with neuromuscular diseases such as CMT are often contradictory and based on theory rather than documented practice. This case report confirms what seems to be the developing consensus in anesthesia that regional management is a safe alternative to general anesthesia in these patients. Considering that CMT is among the most common of hereditary neuromuscular diseases, it seems valid to establish a more research-driven recommendation for practice.
Brock
Macy
M
University of Tennessee at Chattanooga/Erlanger Health System, Nurse Anesthesia Concentration, USA. maceodl@aol.com
Guinn
Cherry
C
Jones
Monica
M
D000328:Adult; D000767:Anesthesia, Epidural / Q000379:methods* / Q000451:nursing; D000773:Anesthesia, Obstetrical / Q000379:methods* / Q000451:nursing; D000775:Anesthesia, Spinal / Q000379:methods* / Q000451:nursing; D002585:Cesarean Section; D002607:Charcot-Marie-Tooth Disease / Q000517:prevention & control*; D055317:Evidence-Based Practice; D005260:Female; D006801:Humans; D048949:Labor Pain / Q000188:drug therapy*; D009719:Nurse Anesthetists; D018579:Patient Selection; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D011256:Pregnancy Outcome