Anesthesia management in a pregnant patient with neurofibromatosis

Abstract

Neurofibromatosis (NF) is a genetic and multisystemic disease with autosomal dominant transition. It can affect anesthesia applications by affecting more than one system. In the presence of neurofibromas in the airway, it can cause airway obstruction and difficulties in respiratory delivery during general anesthesia. The presence of tumors affecting the central nervous system makes spinal anesthesia risky. Anesthesiologists should act with awareness of each multisystemic complication when evaluating and managing patients. This case report aims to present our general anesthesia practice in an elective cesarean operation in a pregnant patient with neurofibromatosis type 1.

Keywords

• Neurofibromatosis
• Pregnant
• General anesthesia

Kaynakça

1. 1. Fox CJ, Tomajian S, Kaye AJ, Russo S, Abadie JV, Kaye AD. Perioperative Management of Neurofibromatosis Type 1. The Ochsner Journal. 2012;12(2):111-21.
2. 2. Hirsch NP, Murphy A, Radcliffe JJ. Neurofibromatosis: Clinical presentations and anaesthetic implications. Br J Anaesth. 2001;86:555-64.
3. 3. Spiegel R, Mächler M, Stocker HP, Boltshauser E, Schmid W. Neurofibromatosis Type 1: Genetic studies with DNA markers in 38 families. Schweiz Med Wochenschr. 1991;121:1445-52.
4. 4. Lee WY, Shin YS, Lim CS, Chung WS, Kim BM: Spinal anesthesia for emergency cesarean section in a preeclampsia patient diagnosed with type 1 neurofibromatosis. Korean Journal of Anesthesiology. 2013;65(6):91-2.
5. 5. Sakai T, Vallejo M, Shannon K. A parturient with neurofibromatosis type 2: anesthetic and obstetric considerations for delivery. International Journal of Obstetric Anesthesia. 2005;14(4):332-5.
6. 6. Jouhilahti EM, Peltonen S, Heape AM, Peltonen J. The pathoetiology of neurofibromatosis 1.Am J Pathol. 2011;178:1932-9.
7. 7. Ferner RE. Neurofibromatosis 1 and neurofibromatosis 2: A twenty first century perspective. Lancet Neurol. 2007;6:340-51.
8. 8. Kanter WR, Eldridge R, Fabricant R, Allen JC, Koerber T. Central neurofibromatosis with bilateral acoustic neuroma: Genetic, clinical and biochemical distinctions from peripheral neurofibromatosis. Neurology. 1980;30:851-9.

9. 9. Hope DG, Mulvihill JJ. Malignancy in neurofibromatosis. Adv Neurol. 1981;29:33-56.
10. 10. Wulf H, Brinkmann G, Rautenberg M. Management of the difficult airway A case of failed fiberoptic intubation. Acta Anaesthesiologica Scandinavica. 1997;41(8):1080-2.
11. 11. Akbarnia BA, Gabriel KR, Beckman E, Chalk D. Prevalence of scoliosis in neurofibromatosis. Spine. 1992;17:244-8.
12. 12. Dayal Y, Tallberg KA, Nunnemacher G, DeLellis RA, Wolfe HJ. Duodenal carcinoids in patients with and without neurofibromatosis. A comparative study. Am J Surg Pathol. 1986;10:348-57.
13. 13. Basile U, Cavallaro G, Polistena A, Giustini S, Orlando G, Cotesta D, et al. Gastrointestinal and retroperitoneal manifestations of type 1 neurofibromatosis. J Gastrointest Surg. 2010;14:186-94.
14. 14. Lovell AT, Alexander R, Grundy EM. Silent, unstable cervical spine injury in multiple neurofibromatosis. Anaesthesia. 1994;49:453-4.
15. 15. Shah S, Murthy PVLN, Gopalkrishnan G, Pandey AP. Neurofibromatosis of the bladder and urethra presenting as obstructive Uropathy. Br J Urol. 1988;61:363–5.
16. 16. Magbagbeola JAO. Abnormal responses to muscle relaxant in a patient with Von Recklinghausen's disease (multiple neurofibromatosis) Br J Anaesth. 1970;42:710.
17. 17. Manser J. Abnormal responses in Von Recklingh-ausen's disease. Br J Anaesth. 1970;42:183.
18. 18. Triplett WW, Ondrey J, McDonald JS. Case report: anesthetic considerations in von Recklinghausen's disease. Anesth Prog. 1980;27:63.
19. 19. Orozco Ariza JJ, Besson A, Pulido Rozo M, Ruiz Roca JA, Linares Tovar, Sáez Yuguero MaR. Neurofibromatosis tipo 1 (NF1) revisión y presentación de un caso clínico con manifestaciones bucofaciales. Av Odontoestomatol. 2005;21:5.
20. 20. Desai A, Carvalho B, Hansen J, Hill J. Ultrasound-guided popliteal nerve block in a patient with malignant degeneration of neurofibromatosis 1. Case Rep Anesthesiol. 2012.
21. 21. Sahin A, Aypar U. Spinal anesthesia in a patient with neurofibromatosis. Anesth Analg. 2003;97:1855-6.
22. 22. Dounas M, Mercier FJ, Lhuissier C, Benhamou D. Epidural analgesia for labour in a parturient with neurofibromatosis. Can J Anaesth. 1995;42:420-4.
23. 23. Esler MD, Durbridge J, Kirby S. Epidural haematoma after dural puncture in a parturient with neurofibromatosis. Br J Anaesth. 2001;87:932-4.
24. 24. Singh T, Hooda S, Anand A, Kaur K, Bala R. Anesthetic consideration in a preeclamptic parturient with Von Recklinghausen’s neurofibromatosis. J Obstet Anaesth Crit Care. 2014;4:38-40.