Neuraxial anaesthesia for caesarean section in a patient with narcolepsy and cataplexy.
We report the management of a morbidly obese parturient suffering from narcolepsy with cataplexy who presented for caesarean section. Her symptoms were controlled by modafinil and fluoxetine. We administered epidural anaesthesia successfully; surgery was uneventful and recovery was uncomplicated. We discuss some of the issues surrounding parturients with narcolepsy including drug therapy and choice of anaesthetic technique.
Soltanifar
S
S
Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, UK. samsoltanifar@aol.com
Russell
R
R
D000328:Adult; D000767:Anesthesia, Epidural; D000773:Anesthesia, Obstetrical; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D001559:Benzhydryl Compounds / Q000627:therapeutic use; D002385:Cataplexy / Q000150:complications*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002585:Cesarean Section; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D000077408:Modafinil; D009290:Narcolepsy / Q000150:complications*; D009767:Obesity, Morbid / Q000150:complications; D011247:Pregnancy
D018687:Antidepressive Agents, Second-Generation; D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D005473:Fluoxetine; D000077408:Modafinil