Hereditary neuropathy with a liability to pressure palsies presenting as a case of sensory neuropathy following spinal anaesthesia for caesarean delivery.

摘要

Neurological complications of obstetric anaesthesia are rare with a reported incidence of permanent damage between 1:24 000 and 1:54 000.u We report a case that illustrates the importance of considering non-anaesthetic and non-surgical causes of neurological disease in patients with new onset postpartum symptoms. A 39-year-old primigravida presented for category 3 caesarean section for failed induction of labour. She gave a past history of back pain, pyelonephritis, bronchitis and bilateral carpal tunnel syndrome. She was fasted and received antacid premedication before surgery. After a 1000 mL infusion of Hartmann's solution, spinal anaesthesia was administered in the sitting position at the L3-4 interspace. Using a 25-gauge Whitacre needle she received 2.5 mL 0.5% hyperbaric bupivacaine and fentanyl 20 ug; there was no paraesthesia on needle insertion or drug injection. Sensory block to T4 to ethyl chloride and pinprick was achieved.