Neuraxial anesthesia in obstetric patients with intracranial hypertension: ten questions and answers


Cite item

Full Text

Abstract

This review covers the actual problem - the use of neuraxial anesthesia in obstetrics in women with intracranial hypertension of various etiologies. Neuraxial anesthesia in pregnant patients with intracranial pathology is possible, but this requires an individual approach, a joint discussion of anesthesiologists, obstetricians, neonatologists and neurologists. An assessment of the likelihood of increased intracranial pressure and related potential adverse effects.

About the authors

Efim M. Shifman

M.F. Vladimirskiy Moscow Regional Scientific and Research Clinical Institute

Email: eshifman@mail.ru
MD, PhD, DSc, Professor, Department of Anesthesiology and Resuscitation, M.F. Vladimirskiy Moscow Regional Scientific and Research Clinical Institute 129110, Moscow

R. R Arustamyan

A.I. Evdokimov Moscow State Medical Stomatological University

127473, Moscow

A. U Lubnin

N.N. Burdenko Scientific Research Neurosurgery Institute

125047, Moscow

A. V Kulikov

Ural State Medical University

620028, Yekaterinburg

References

  1. Шифман Е.М., Филиппович Г. В. Осложнения нейроаксиальных методов обезболивания в акушерстве: тридцать вопросов и ответов. Регионарная анестезия и лечение острой боли. 2006; 1(0): 35-54.
  2. Шифман Е.М., Филиппович Г.В. Эпидуральная анестезия как метод обезболивания операции кесарева сечения: тридцать вопросов и ответов (часть I). Регионарная анестезия и лечение острой боли. 2007; I(1): 61-71.
  3. Шифман Е.М., Филиппович Г.В. Эпидуральная анестезия как метод обезболивания операции кесарева сечения: тридцать вопросов и ответов (часть II). Регионарная анестезия и лечение острой боли. 2007; I(2): 83-93.
  4. Шифман Е. М., Филиппович Г. В. Эпидуральная анестезия как метод обезболивания операции кесарева сечения: тридцать вопросов и ответов (часть III). Регионарная анестезия и лечение острой боли. 2007; I(3): 57-67.
  5. Шифман Е.М., Флока С.Е. Особенности проведения анестезии у пациенток с заболеваниями нервной системы - безопасны ли нейроаксиальные методы анестезии? Анестезиология и реаниматология. 2010; 3: 63-9.
  6. Beni-Adani L., Pomeranz S., Flores I., Shoshan Y., Ginosar Y., Ben-Shachar I. Huge acoustic neurinomas presenting in the late stage of pregnancy. Treatment options and review of literature. Acta Obstet Gynecol Scand. 2001; 80: 179-84.
  7. Boker A., Ong By. Anesthesia for Cesarean section and posterior fossa craniotomy in a patient with von Hippel-Lindau disease. Can J Anaesth. 2001; 48: 387-90.
  8. Tewari K.S., Cappuccini F., Asrat, Flamm B.L., Carpenter Se, Disaia P.J., Quilligan E.J. Obstetric emergencies precipitated by malignant brain tumors. Am J Obstet Gynecol. 2000; 182: 1215-21.
  9. Шифман Е.М., Гуменюк Е.Г., Ившин А.А. Диагностика поражений головного мозга у беременных с преэклампсией и эклампсией. Акушерство и гинекология. 2004; 6: 6-8.
  10. Weerakkody R.A., Czosnyka M., Schuhmann M.U., Schmidt, Keong N., Santarius T., Pickard J.D., Czosnyka Z. Clinical assessment of cerebrospinal fluid dynamics in hydrocephalus. Guide to interpretation based on observational study. Acta Neurol Scand. 2011; 124: 85-98.
  11. Mokri B. the Monro-Kellie hypothesis: Applications in CSF volume depletion. Neurology. 2001; 56: 1746-8.
  12. Шифман Е.М., Гуменюк Е.Г., Ившин А.А. Некоторые вопросы диагностики поражений головного мозга у беременных с преэклампсией и эклампсией. Новости науки и техн. Сер. Мед. Вып. Реаниматология. Интенсивная терапия. Анестезиология / ВИНИТИ. 2003; 2: 13-7.
  13. Nevo O., Soustiel J.F., Thaler I. Maternal cerebral blood flow during normal pregnancy: a cross-sectional study. Am J Obstet Gynecol. 2010; 203 (475): 1-6.
  14. Ившин А.А., Гуменюк Е.Г., Шифман Е.М. Компенсаторные механизмы регуляции мозгового кровообращения при прогрессировании беременности. Журнал Российского общества акушеров-гинекологов. 2004; 4: 26-7.
  15. Marx G.F., Zemaitis M.T., Orkin L.R. Cerebrospinal fluid pressures during labor and obstetrical anesthesia. Anesthesiology. 1961; 22: 348-54.
  16. Onuki E., Higuchi H., Takagi S. et al. Gestation-related reduction in lumbar cerebrospinal fluid volume and dural sac surface area. Anesth Analg. 2010; 110: 148-53.
  17. Citerio G., Andrews P.J. intracranial pressure. Part two: Clinical applications and technology. Intensive Care Med. 2004; 30: 1882-5.
  18. Friese S., Hamhaber U., Erb M, Klose U: B-waves in cerebral and spinal cerebrospinal fluid pulsation measurement by magnetic resonance imaging. J Comput Assist tomogr. 2004; 28: 255-62.
  19. Hogan Q.H., Prost R., Kulier A., Taylor M.L., Liu S., Mark L. Magnetic resonance imaging of cerebrospinal fluid volume and the influence of body habitus and abdominal pressure. Anesthesiology. 1996; 84: 1341-49.
  20. Hopkins E.L., Hendricks C.H., Cibils L.A: Cerebrospinal fluid pressure in labor. Am J Obstet Gynecol. 1965; 93: 907-16.
  21. Grocott H.P., Mutch W.A. Epidural anesthesia and acutely increased intracranial pressure. Lumbar epidural space hydrodynamics in a porcine model. Anesthesiology. 1996; 85: 1086-91.
  22. Galbert M.W., Marx G.F. Extradural pressures in the parturient patient. Anesthesiology. 1974; 40: 499-502.
  23. Hilt H., Gramm H.J., Link J: Changes in intracranial pressure associated with extradural anaesthesia. Br J Anaesth. 1986; 58: 676-80.
  24. Finfer S.R. Management of labour and delivery in patients with intracranial neoplasms. Br J Anaesth.1991; 67: 784-7.
  25. Qaiser R., Black P. Neurosurgery in pregnancy. Semin Neurol. 2007; 27: 476-81.
  26. Stevenson C.B., Thompson R.C. the clinical management of intracranial neoplasms in pregnancy. Clin Obstet Gynecol. 2005; 48: 24-37.
  27. Шифман Е.М, Орджоникидзе Н.В., Полянчикова О.Л., Флока С.Е., Бурдули Г.М. и др. Гемангиоперицитома мозжечка, манифестировавшая во время беременности. Клиническое наблюдение с благоприятным исходом. Акушерство и гинекология. 2011; 7/1: 73-9.
  28. May A., Fombon F.N., Francis S. UK registry of high-risk obstetric anaesthesia: Report on neurological disease. Int J Obstet Anesth. 2008; 17: 31-6.
  29. Terauchi M., Kubota T., Aso T., MaeharaT. Dysembryoplastic neuroepithelial tumor in pregnancy. Obstet Gynecol. 2006; 108 (3 Pt 2): 730-2.
  30. Chang Ly., Carabuena J.M., Camann W. Neurologic issues and obstetric anesthesia. Semin Neurol. 2011; 31: 374-84.
  31. Schwartz R.B., Feske S.K., Polak J.F. et al. Preeclampsia-eclampsia: Clinical and neuroradiographic correlates and insights into the pathogenesis of hypertensive encephalopathy. Radiology. 2000; 217: 371-6.
  32. French J.L., McCullough J., Bachra P., Bedforth N.M. transversus abdominis plane block for analgesia after caesarean section in a patient with an intracranial lesion. Int J Obstet Anesth. 2009; 18: 52-4.
  33. Mamelak A.N., Withers G.J., Wang X. Choriocarcinoma brain metastasis in a patient with viable intrauterine pregnancy. Case report. J Neurosurg. 2002; 97: 477-81.
  34. van Crevel H., Hijdra A., de Gans J. Lumbar puncture and the risk of herniation: When should we first perform Ct? J Neurol. 2002; 249: 129-37; Joffe A.R. Lumbar puncture and brain herniation in acute bacterial meningitis: A review. J intensive Care Med. 2007; 22: 194-207.
  35. Hasbun R., Abrahams J., Jekel J., Quagliarello V.J. Computed tomography of the head before lumbar puncture in adults with suspected meningitis. N Engl J Med. 2001; 345: 1727-33.
  36. Флока С.Е., Шифман Е.М. Поражение черепно-мозговых нервов после нейроаксиальных методов обезболивания у родильниц. Анестезиология и реаниматология. 2007; 2: 58-61.
  37. Karmaniolou, Petropoulos G., Theodoraki K. Management of idiopathic intracranial hypertension in parturients: Anesthetic considerations. Can J Anaesth 2011; 58: 650-7.
  38. Alperin N., Ranganathan S., Bagci A.M., Adams D.J., ertl-Wagner B., Saraf-Lavi, Sklar eM., Lam B.L. MRi evidence of impaired CSF homeostasis in obesity-associated idiopathic intracranial hypertension. Am J Neuroradiol. 2013; 34: 29-34.
  39. Aly Е.Е., Lawther B.K. Anaesthetic management of uncontrolled idiopathic intracranial hypertension during labour and delivery using an intrathecal catheter. Anaesthesia. 2007; 62: 178-81.
  40. Kaul B., Vallejo M.C., Ramanathan S., Mandell G.L., Krohner R.G. Accidental spinal analgesia in the presence of a lumboperitoneal shunt in an obese parturient receiving enoxaparin therapy. Anesth Analg .2002; 95: 441-3.
  41. Heckathorn J., Cata J.P., Barsoum S. Intrathecal anesthesia for cesarean delivery via a subarachnoid drain in a woman with benign intracranial hypertension. Int J Obstet Anesth. 2010; 19: 109-11.
  42. Kim K., Orbegozo M. Epidural anesthesia for cesarean section in a parturient with pseudotumor cerebri and lumboperitoneal shunt. J Clin Anesth. 2000; 12: 213-5.
  43. Worrell J., Lane S. Impact of pseudotumor cerebri (idiopathic intracranial hypertension) in pregnancy: A case report. AANAJ. 2007; 75: 199-204.
  44. Hollister N., Todd C., Ball S., thorp-Jones D, Coghill J: Minimising the risk of accidental dural puncture with epidural analgesia for labour: A retrospective review of risk factors. Int J Obstet Anesth. 2012; 21: 236-41.
  45. Cruickshank R.H., Hopkinson J.M. Fluid flow through dural puncture sites. An in vitro comparison of needle point types. Anaesthesia. 1989; 44: 415-8.
  46. Angle P.J., Kronberg Je., Thompson D.E., Ackerley C., Szalai J.P., Duffin J, Faure P. Dural tissue trauma and cerebrospinal fluid leak after epidural needle puncture: effect of needle design, angle, and bevel orientation. Anesthesiology. 2003; 99: 1376-82.
  47. Grant R., Condon B., Hart I., Teasdale G.M. Changes in intracranial CSF volume after lumbar puncture and their relationship to post-LP headache. J Neurol Neurosurg Psychiatry. 1991; 54: 440-2.
  48. Warwick Wi, Neal J.M. Beyond spinal headache: Prophylaxis and treatment of low-pressure headache syndromes. Reg Anesth Pain Med. 2007; 32: 455-61.
  49. Atanassoff P.G., Alon e, Weiss B.M., Lauper U. Spinal anaesthesia for caesarean section in a patient with brain neoplasma. Can J Anaesth. 1994; 41: 163-4.
  50. Innamaa A., Deering P., Powell M.C. Advanced lung cancer presenting with a generalized seizure in pregnancy. Acta Obstet Gynecol Scand. 2006; 85: 1148-9.
  51. Sut M., Lan C.M., Yang L.C., Leet C., Wang K.W., Hung K.S. Brain tumor presenting with fatal herniation following delivery under epidural anesthesia. Anesthesiology. 2002; 96: 508-9.
  52. Goroszeniuk, Howard R.S., Wright Jt. The management of labour using continuous lumbar epidural analgesia in a patient with a malignant cerebral tumour. Anaesthesia. 1986; 41: 1128-9.
  53. Bharti N., Kashyap L., Mohan V.K. Anesthetic management of a parturient with cerebellopontine-angle meningioma. Int J Obstet Anesth. 2002; 11: 219-21.
  54. Wang L.P., Paech M.J. Neuroanesthesia for the pregnant woman. Anesth Analg. 2008; 107: 193-200.
  55. Davie C.A., O’Brien P. Stroke and pregnancy. J Neurol Neurosurg Psychiatry. 2008; 79: 240-5.
  56. D’Haese J., Christiaens F., D’Haens J., Camu F. Combined cesarean section and clipping of a ruptured cerebral aneurysm: A case report. J Neurosurg Anesthesiol. 1997; 9: 341-5.
  57. Stoodley M.A., Macdonald R.L., Weir B.K. Pregnancy and intracranial aneurysms. Neurosurg Clin N Am. 1998; 9: 549-5689.
  58. Dias M.S., Sekhar L.N. Intracranial hemorrhage from aneurysms and arteriovenous malformations during pregnancy and the puerperium. Neurosurgery. 1990; 27: 855-65.
  59. Horton J.C., Chambers W.A., Lyons S.L., Adams R.D., Kjellberg R.N. Pregnancy and the risk of hemorrhage from cerebral arteriovenous malformations. Neurosurgery. 1990; 27: 867-71.
  60. Tiel Groenestege A., Rinkel G.J., van der Bom J.G., Algra A., Klijn C.J. the risk of aneurysmal subarachnoid hemorrhage during pregnancy, delivery, and the puerperium in the Utrecht population: Case-crossover study and standardized incidence ratio estimation. Stroke. 2009; 40: 1148-51.
  61. Bateman B., Olbrecht V.A., Berman M.F., Minehart R.D., Schwamm L.H., Leffert L.R. Peripartum subarachnoid hemorrhage: Nationwide data and institutional experience. Anesthesiology. 2012; 116: 324-33.
  62. Whitburn R.H., Laishley R.S., Jewkes D.A. Anaesthesia for simultaneous caesarean section and clipping of intracerebral aneurysm. Br J Anaesth. 1990; 64: 642-5.
  63. Gross B.A., Du R. Hemorrhage from arteriovenous malformations during pregnancy. Neurosurgery. 2012; 71: 349-55.
  64. Le L., Wendling A. Anesthetic management for cesarean section in a patient with rupture of a cerebellar arteriovenous malformation. J Clin Anesth. 2009; 21:143-8.
  65. Шифман Е.М., Куликов А.В., Лубнин А.Ю., Дробинская А.Н., Флока С.Е. Интракраниальные артериовенозные мальформации во время беременности, родов и послеродового периода. Анестезиология и реаниматология. 2014; 1: 85-7.
  66. Elias M., Abouleish E., Bhandari A. Arteriovenous malformation during pregnancy and labor-Case review and management. Middle East J Anesthesiol. 2001; 16: 231-7.
  67. Viscomi C.M., Wilson J., Bernstein. Anesthetic management of a parturient with an incompletely resected cerebral arteriovenous malformation. Reg Anesth. 1997; 22: 192-7.
  68. Sharma S.K., Herrerae R., Sidawi Je., Leveno K.J. The pregnant patient with an intracranial arteriovenous malformation. Cesarean or vaginal delivery using regional or general anesthesia? Reg Anesth. 1995; 20: 455-8.
  69. O’Connor K., Rees S.G. Anaesthetic management for caesarean section in moyamoya disease. Int J Obstet Anesth. 2007; 16: 94.
  70. Dutta B., Dehran M., Sinha R. Anaesthetic management of a parturient with moyamoya disease. Singapore Med J. 2011; 52: e108-10.
  71. Thomas J.S., Koh S.H., Cooper G.M. Haemodynamic effects of oxytocin given as i.v. bolus or infusion on women undergoing Caesarean section. Br J Anaesth. 2007; 98: 116-9.
  72. Thiagarajah S., Lear E., Azar I. The effects of oxytocin on intracranial pressure. J Neurosurg Anesthesiol. 1991; 3: 270-2.
  73. Chang L., Looi-Lyons L., Bartosik L., Tindal S. Anesthesia for cesarean section in two patients with brain tumours. Can J Anaesth. 1999; 46: 61-5.
  74. Svanstrom M.C., Biber B., Hanes M., Johansson G., Naslund U., Balfors E.M. Signs of myocardial ischaemia after injection of oxytocin: a randomized double-blind comparison of oxytocin and methylergometrine during Caesarean section. Br J Anaesth. 2008; 100: 683-9.
  75. Klein J.P., Hsu L. Neuroimaging during pregnancy. Semin Neurol. 2011; 31: 361-73.

Copyright (c) 2016 Eco-Vector


 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies