Anaesthesia for caesarean section in a patient with lumbar syringomyelia.

BACKGROUND AND OBJECTIVES

Syringomyelia is a rare neurological condition characterized by the presence of an expansive cystic cavity in the spinal cord, resulting in several neurologic manifestations. The objective of the present report was to address the safety of general anesthesia in this group of patients.

CASE REPORT

This is a 28-year old primipara with lumbar syringomyelia scheduled for lower segment cesarean section (LSC). Surgery was performed under general anesthesia without complications. General anesthesia was chosen for this patient to avoid manipulation of the subarachnoid space during neuraxial anesthesia, which could cause changes in intracranial pressure or worsening neurological symptoms. We used rocuronium considering that it avoids rising in cerebrospinal fluid pressure and hyperkalemia that can be seen with succinylcholine.

CONCLUSIONS

General anesthesia can be safely used in patients with syringomyelia. Care should be taken to prevent increase in intracranial pressure and neuromuscular blockade should be monitored.