Abstract
The first report of epidural analgesia for labour in a 26-yr-old woman with von Recklinghausen’s neurofibromatosis is described. Epidural anaesthesia is often considered as contraindicated because neurofibromas may involve spinal cord and nerve roots. However, general anaesthesia was considered at high risk for this parturient on the basis of her previous medical and surgical history and of physical findings. The present observation suggests that epidural analgesia may be used in such circumstances provided that spinal cord neurofibromas have been ruled out by clinical and CT scan (or magnetic resonance imaging) examination.
Résumé
Les auteurs rapportent le premier cas d’analgésie péridurale pour l’accouchement chez une parturiente de 26 ans atteinte de neurofibromatose de Von Recklinghausen. L’analgésie péridurale est déconseillée voire contre-indiquée pour de nombreux auteurs en raison de la possible localisation radiculaire des neurofibromes. Cependant cette patiente a un lourd passé médicochirurgical rendant la pratique de l’anesthésie générale très risquée. Cette observation montre que l’analgésie péridurale peut être utilisée dans cette situation, à condition d’avoir éliminé par un examen clinique et radiologique (scanner ou IRM) la localisation d’un neurofibrome sur les racines lombaires correspondant à l’espace de ponction.
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Dounas, M., Mercier, F.J., Lhuissier, C. et al. Epidural analgesia for labour in a parturient with neurofibromatosis. Can J Anaesth 42, 420–424 (1995). https://doi.org/10.1007/BF03015490
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DOI: https://doi.org/10.1007/BF03015490