Epidural Analgesia Complicated by Dural Ectasia in the Marfan Syndrome

Vacula, Benjamin B.; Gray, Chelsea; Hofkamp, Michael P.; Noonan, Patrick T.; McAllister, Russell K.; Pilkinton, Kimberly; Diao, Zhiying

doi:10.1080/08998280.2016.11929477

Cited by 6 publications

(3 citation statements)

References 7 publications

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“…6 Patients with Marfan syndrome also have a predisposition for dural ectasia, which increases the risk of unintentional dural puncture. 7 The evidence regarding the safety of neuraxial anesthetic techniques in patients with multiple sclerosis, particularly subarachnoid blocks, is mixed. 8 However, a survey among anesthesiologists in the United Kingdom found that 98% would perform a neuraxial technique for cesarean delivery.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic management for cesarean section and tubal ligation in a patient with Marfan syndrome, multiple sclerosis, and multiple postdural puncture headaches

Hofkamp

Galvan

2018

Baylor University Medical Center Proceedings

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We report a 29-year-old woman with Marfan syndrome, multiple sclerosis, and multiple postdural puncture headaches who presented for a scheduled repeat cesarean delivery with bilateral tubal ligation at 37 weeks gestation. During an outpatient preoperative visit, a general anesthetic plan was ultimately selected through a shared decision-making process. The patient had an uneventful general anesthetic that included a rapid sequence induction with direct laryngoscopy. Neonatal Apgar scores were 8 at 1 minute and 9 at 5 minutes. Prior to emergence, fentanyl, acetaminophen, and ketorolac were administered intravenously and a transversus abdominus plane block was performed. On the first postoperative day, the patient expressed satisfaction with the anesthetic plan and, in particular, the avoidance of a neuraxial technique and postdural puncture headache. The patient was discharged on the second postoperative day with no apparent sequelae. A neuraxial anesthetic technique is usually preferred in patients undergoing cesarean delivery, and it is safe to perform this technique in patients with either Marfan syndrome or multiple sclerosis. We formulated an anesthetic plan that honored our patient's autonomy and produced a good maternal and neonatal outcome.

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Section: Discussionmentioning

confidence: 99%

Anesthetic management for cesarean section and tubal ligation in a patient with Marfan syndrome, multiple sclerosis, and multiple postdural puncture headaches

Hofkamp

Galvan

2018

Baylor University Medical Center Proceedings

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“…69 Administering epidural anesthesia can be complicated by lumbosacral dural ectasia. 70 Whether this becomes more of a problem as older people with MFS require more surgical procedures is not clear.…”

Section: Nervous Systemmentioning

confidence: 99%

Marfan syndrome: improved clinical history results in expanded natural history

Pyeritz

2019

Genetics in Medicine

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“…When the patient wakes up after anesthesia, the relevant nurse should carefully check whether the related nerve function of the patient is normal, observe the related lying posture, at the same time, move the left and right limbs of the patient, observe whether there is hemiplegia, raise the lower limbs of the patient up and down, first close the eyes of the patient from the paralyzed side, observe the response of light stimulation, and use needle light stimulation or cotton swab friction to stimulate the left and right In addition, the nursing staff should also pay attention to the patient's self-feeling. When the patient complains that the lower limbs cannot move normally, the nursing staff should check the patient's relevant situation and inform the doctor in time [10].…”

Section: Microsurgical Nursing Of Dural Arteriovenous Fistulamentioning

confidence: 99%

Microsurgical Repair of Dura Mater Rupture Caused by Movement

2020

IJHPM

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With the increasing of medical technology, the demand for the repair of the related tissue and organ injury is also growing. At the same time, microsurgery plays an increasingly important role in the successful completion of difficult operations. After the end of spinal surgery, dural rupture and cerebrospinal fluid leakage are relatively common complications. In order to study the micro repair technique of dural rupture caused by surgery, 30 patients with dural rupture were selected in this paper. After MRI showed that there was suspected vascular lesions in spinal canal, all cases were confirmed by digital subtraction angiography. This study showed that after microsurgery, there were 20 patients with excellent evaluation grade, and the average score of aminov score was 0.6, accounting for 80% of the total number of patients; 5 patients with good evaluation grade, with an average score of 4.5 points, accounting for 10% of the total number; 3 patients with medium evaluation grade, with an average score of 6.2 points, accounting for 7% of the total number; 2 patients with poor evaluation grade, with an average score of 8.9 points, accounting for 3% of the total number. In the related evaluation of comprehensive efficacy, 23 cases were cured, accounting for 73% of the number of researchers, 5 cases were improved, accounting for 17% of the number of researchers, 2 cases were unchanged, accounting for 10% of the number of researchers, and there was no worsening case. Therefore, for the dural rupture caused by exercise, the treatment of dural rupture during operation and the comprehensive treatment after operation are very important.

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Epidural Analgesia Complicated by Dural Ectasia in the Marfan Syndrome

Cited by 6 publications

References 7 publications

Anesthetic management for cesarean section and tubal ligation in a patient with Marfan syndrome, multiple sclerosis, and multiple postdural puncture headaches

Anesthetic management for cesarean section and tubal ligation in a patient with Marfan syndrome, multiple sclerosis, and multiple postdural puncture headaches

Marfan syndrome: improved clinical history results in expanded natural history

Microsurgical Repair of Dura Mater Rupture Caused by Movement

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