Intravenous Remifentanil Analgaesia for an Obstetric Patient with Type I Neurofbromatosis and a Factor V Leiden Mutation
Journal Title: Sultan Qaboos University Medical Journal - Year 2017, Vol 17, Issue 4
Abstract
Type I neurofbromatosis is characterised by altered skin pigmentation and the growth of benign tumours, particularly along the peripheral nerves and central nervous system. We report a 36-year-old primigravida woman in labour who was admitted to the obstetric suite of the Hospital Sant Joan de Déu, Barcelona, Spain, in 2007 with hypothyroidism, type I neurofbromatosis and a factor V Leiden mutation. Due to a lack of cranial and spinal imaging data, an epidural was not indicated; instead, continuous intravenous remifentanil analgaesia was administered. Te remifentanil infusion was self-titrated by the patient using a visual analogue scale, with the dosage ranging from 0.01 to 0.25 μg/kg/minute. Due to rotational dystocia, Kjelland-type forceps were used during the delivery. After birth, the infant was found to have Apgar scores of 9 and 10, with no maternal or neonatal adverse effects observed. Although still controversial, remifentanil may be a successful alternative for analgaesia in similar cases; however, the specifc risks and benefts for each patient should be considered prior to administration.
Authors and Affiliations
José L. Gálvez| Department of Anaesthesiology, Resuscitation & Pain Therapeutics, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain, Carlos L. Errando| Departments of Surgical Services and Anaesthesiology, Resuscitation & Pain Therapeutics, Consorcio Hospital General Universitario de Valencia, Valencia, Spain, Silvia Serrano| Department of Anaesthesiology, Resuscitation & Pain Therapeutics, Hospital Sant Joan de Déu, Barcelona, Spain, Marga Martín-Ayuso| Department of Anaesthesiology, Resuscitation & Pain Therapeutics, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain, José M. Valverde-Mantecón| Department of Anaesthesiology, Resuscitation & Pain Therapeutics, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
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- EP ID EP14827
- DOI 10.18295/squmj.2017.17.04.016
- Views 338
- Downloads 17
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