Anesthetic management for cesarean delivery in a Guillain-Barré syndrome patient -A case report-

Abstract

Guillain-Barré syndrome is an acute inflammatory demyelinating polyradiculopathy characterized by progressive motor weakness, areflexia, and ascending paralysis. Guillain-Barré syndrome is extremely rare in pregnant patients, and there are no established guidelines for delivery or safest anesthetic methods. We report a Cesarean delivery in the case of a 32-year old woman who was diagnosed with Guillain-Barré syndrome 18 weeks into gestation. Tracheostomy was performed due to progressive respiratory muscle weakness and respiratory failure, and ventilator support was required in the intensive care unit. The respiratory difficulty was exacerbated by the growth of the fetus, necessitating emergency Cesarean delivery. The delivery was successfully performed under general anesthesia, and the patient recovered without neurological sequelae.

Guillain-Barre Syndrome With Concomitant Severe Preeclampsia: A Case Report

“…If general anesthesia is considered, succinylcholine should be avoided and replaced with a nondepolarizing muscle relaxant due to an increased risk of hyperkalemia. However, the use of nondepolarizing neuromuscular blocking agents on these patients with GBS presents the risk of prolonged blockade, requiring ventilatory support postoperatively [ 19 ].…”

Anaesthetic Management of a Patient with Gullain Barre Syndrome Posted for Emergency Caesarean Section: A Case Report

“…[1] Diagnostic criteria of GBS are (a) relatively symmetrical weakness of two or more limbs due to neuropathy, (b) areflexia, (c) disorder course less than 4 weeks, (d) exclusion of other causes like absence of fever, (e) typical CSF finding on lumbar puncture, (f) and electrophysiological evidence of demyelination from electromyogram. [3] The appropriate mode of delivery and anesthetic management of parturient patient with GBS depends on patient's clinical condition at the time of delivery. There are no established guidelines for safe anaesthetic techniques in such cases.…”