Abstract
IntroductionPolymyositis which is a rare disease both in general population and in pregnancy is systemic connective tissue disorder characterized by inflammation and degeneration of muscles. There is only a little information relating to the anesthetic management of a pregnant woman with polymyositis.Case presentationIn this article, we present anesthetic management of urgent cesarean delivery of a 28-year-old parturient with polymyositis under epidural anesthesia who was diagnosed with polymyositis five years ago and has been treated regularly with different doses prednisolone since then.ConclusionIn a parturient with polymyositis, it should not be suggested general anesthesia due to risks including delayed recovery from muscle relaxation, aspiration pneumonitis, arrhythmias, cardiac failure, we consider that epidural anesthesia for cesarean section can be safely applied.
Highlights
Polymyositis which is a rare disease both in general population and in pregnancy is systemic connective tissue disorder characterized by inflammation and degeneration of muscles
Polymyositis (PM) with the prevalence from 2.4-10.7 cases per 100.000 persons in the general population is characterized by symmetric proximal muscle weakness, increased serum skeletal muscle enzymes, electromyography (EMG) abnormalities and inflammatory cell infiltrates in muscle tissue
We present our case report on the grounds that there are only a few reports available in literature on the anesthetic management of polymyositis in pregnant women [5,6]
Summary
As far as delayed recovery from muscle relaxation, aspiration pneumonitis, arrhythmias, cardiac failure and steroid supplementation with its complications are concerned as the major concerns for an anesthesiologist; we consider that epidural anesthesia for cesarean section in a pregnant woman with polymyositis can be safely applied. PM: polymyositis; EMG: electromyography; AST: aspartate aminotransferase; ALT: alanine aminotransferase; LDH: lactate dehydrogenase; CK: creatine kinase; ECG: electrocardiogram; CPK: creatine phosphokinase; CSF: cerebrospinal fluid volume; FRC: functional residual capacity; CSE: combined spinal-epidural. Written informed consent was obtained from the patient for publication of this case report. A copy of the written http://www.casesjournal.com/content/2/1/9107 consent is available for review by the Editor-in-Chief of this journal
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