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Case Reports
. 2014 Jul;8(3):402-5.
doi: 10.4103/1658-354X.136633.

Anesthetic management of a patient with multiple sclerosis undergoing cesarean section with low dose epidural bupivacaine

Sameer Sethi  1 , Sonia Kapil  1
Affiliations
Case Reports

Anesthetic management of a patient with multiple sclerosis undergoing cesarean section with low dose epidural bupivacaine

Sameer Sethi et al. Saudi J Anaesth. 2014 Jul.

Abstract

A 32-year-old Indian female 38 weeks pregnant, with a history of multiple sclerosis since 2008 was admitted in obstetric ward for safe confinement. She had a history of diminution of vision in both eyes and limb weakness, relapsing - remitting type with movement-induced muscle spasms, in all the four limbs. Her symptoms were usually diplopia, difficulty in vision and ataxic gait. Sh was then treated with methylprednisolone. She was on oral dimethyl fumarate trial, which was stopped at the beginning of pregnancy. Presently, she was completely asymptomatic. Epidural anesthesia with an indwelling catheter was administered with 15 ml of 0.25% bupivacaine in 5 ml increments. A total of 3 mg of epidural morphine was given for post-operative analgesia. The surgery evolved without any intercurrences and patient was discharged from the hospital 72 h after surgery without worsening of her symptoms. We report a safe anesthetic management of a patient with MS undergoing cesarean section with low dose epidural bupivacaine with the addition of morphine for post-operative analgesia.

Keywords: Cesarean section; epidural anesthesia; multiple sclerosis; opioid.

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Conflict of interest statement

Conflict of Interest: None declared

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