Anesthésie et recherche clinique
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A Combined Spinal Epidural Anesthetic (CSE) for Cesarean Section in a Patient with Achondroplasia. Can MRI be Helpful?

Antonio Gonzalez Fiol, Mark Escudero, Sherelle Laifer-Narin and Richard Smiley

The anatomic features of achondroplastic patients pose many challenges for anesthesiologists. The
achondroplastic parturient has a high likelihood of delivery by cesarean section due to cephalopelvic disproportion.
Hence, anesthesiologist involvement is crucial. It is not uncommon for these patients to have a narrow spinal canal
and areas of spinal stenosis. These features might prove a challenge for a neuraxial technique and potentially result
in unpredictable spread of local anesthetic. We present a case in which an abnormal Magnetic Resonance Imaging
(MRI) was used to tailor the anesthetic plan for an achondroplastic parturient and possibly explain some of our
intraoperative observations.