Anesthesia for cesarean section in a patient with achondroplasia

Introduction: Cesarean section under general anesthesia is recommended in achondroplastic pregnant patients; however, the use of conductive techniques has been recently reported, with acceptable results. Objective: To describe the anesthesia management in an achondroplastic patient scheduled for C-section under combined spinal–epidural anesthesia. Methods and results: We present the case of a first pregnancy in a patient with achondroplasia, height 110 cm and 37 weeks of gestation. The patient underwent cesarean section under ultrasound-guided conductive anesthesia, using a titrated mixture of local anesthetic and opiate, with good results for the mother and child. Conclusions: Conductive anesthesia is an option in C-section in patients with achondroplasia. Although there are no clear recommendations to guide a safe access to the neuroaxis or to administer anesthetic agents at this level, ultrasound and the titrated administration of neuraxial drugs (epidural, epidural–spinal and continuous spinal) for improved safety and efficacy of the technique in this type of patients may be considered. © 2012 Published by Elsevier Espana, S.L. on behalf of Sociedad Colombiana de Anestesiologia y Reanimacion.