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BJA Advance Access published online on March 10, 2006
British Journal of Anaesthesia, doi:10.1093/bja/ael056
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Accepted February 7, 2006

Case Report

Caesarean section in a patient with torsion dystonia

A. J. Olufolabi 1 * and M. Y. K. Wee 2

1 Duke University Medical Center, Durham, NC 27710, USA
2 Poole Hospital NHS Trust, Longfleet Road, Poole, Dorset BH15 2JB, UK

* To whom correspondence should be addressed.
A. J. Olufolabi, E-mail: olufo001{at}mc.duke.edu


  Abstract

We present a case of torsion dystonia in a 35-yr-old primigravida who presented for a Caesarean section under general anaesthesia. She had limb contractures and severe kyphoscoliosis associated with limited respiratory reserve and function. General anaesthesia was induced using thiopental and divided doses of mivacurium for rapid sequence induction. After the delivery of a healthy male baby, she received i.v. morphine and bilateral iliohypogastric, ilioinguinal blocks and had an uneventful recovery. Technical issues of supine positioning, intubation and respiratory support need to be considered during anaesthesia planning. Although regional anaesthesia is commonly offered for caesarean section, maternal compromise and technical factors may preclude this approach.

Keywords: anaesthesia, general; complications, kyphoscoliosis; pregnancy.
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This article has been cited by other articles:


Home page
 Br J AnaesthHome page
J. Geoghegan, A. J. Olufolabi, and M. Y. K. Wee
Caesarean section in a patient with torsion dystonia.
Br. J. Anaesth., September 1, 2006; 97(3): 424 - 425.
[Full Text] [PDF]

E-letters:

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Caesarean section in a patient with torsion dystonia - a response
James Geoghegan
British Journal of Anaesthesia, 10 May 2006 [Full text]
Caesarean section for torsion dystonia
Adeyemi J Olufolabi, et al.
British Journal of Anaesthesia, 26 May 2006 [Full text]
Metaclopramide is not safe as premedication in patients with torsion dystonia undergoing surgery
Ravindra Kumar Pandey, et al.
British Journal of Anaesthesia, 26 Feb 2007 [Full text]

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