title: Anesthetic considerations in a parturient with congenital insensitivity to pain with anhidrosis.
abstract: Congenital insensitivity to pain is a rare autosomal recessive disease characterized by varying degrees of autonomic dysfunction and sensory loss, including nociceptive hyposensitivity. It is this autonomic dysfunction that makes both general and neuraxial anesthesia challenging. Testing the block during neuraxial anesthesia may be difficult and the patient may be prone to hypotension and bradycardia. This case report describes the anesthetic management of a parturient with congenital insensitivity to pain presenting for cesarean delivery.
authors.affiliation: Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, London, Ontario, Canada. Electronic address: zpirani@uwo.ca.
authors.forename: Z
authors.initials: Z
authors.lastname: Pirani
authors.affiliation: Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: F
authors.initials: F
authors.lastname: Qasem
authors.affiliation: Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Katsiris
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D002585:Cesarean Section; D005260:Female; D009477:Hereditary Sensory and Autonomic Neuropathies / Q000150:complications*; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications
keywords: Cesarean delivery; Congenital insensitivity to pain; Spinal anesthesia