Anesthetic management of an obstetric patient with CMT: a case study

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AANA J. 2009 Oct;77(5):335-7.

Anesthetic management of an obstetric patient with Charcot-Marie-Tooth disease:

a case study.

Brock M, Guinn C, M.

University of Tennessee at Chattanooga/Erlanger Health System, Nurse Anesthesia

Concentration, USA.

Additional documentation of regional anesthesia in patients with

Charcot-Marie-Tooth disease (CMT) is needed to guide practitioners and patients

in exploring appropriate options for anesthesia and analgesia management. This

case report describes the successful use of a combined spinal-epidural technique

for labor progressing to cesarean delivery in a patient with CMT. Previous

similar case reports were reviewed and an extensive literature search was

conducted to organize the limited body of research regarding use of regional

anesthesia in patients with CMT. Opinions regarding regional anesthesia in

patients with neuromuscular diseases such as CMT are often contradictory and

based on theory rather than documented practice. This case report confirms what

seems to be the developing consensus in anesthesia that regional management is a

safe alternative to general anesthesia in these patients. Considering that CMT

is among the most common of hereditary neuromuscular diseases, it seems valid to

establish a more research-driven recommendation for practice.