• J Clin Anesth · May 2002

    Review

    Chiari I malformation in parturients.

    • Robert C Chantigian, Monica A Koehn, Kirk D Ramin, and Mark A Warner.
    • Department of Anesthesiology, Perioperative Outcomes Group, Mayo Clinic, Rochester, MN 55905, USA. chantigian.robert@mayo.edu
    • J Clin Anesth. 2002 May 1; 14 (3): 201-5.

    Study ObjectiveTo assess complications of regional as well as general anesthesia in parturients with Chiari I malformation.DesignRetrospective chart review.SettingAcademic medical center.PatientsAll parturients in our institution who had the diagnosis of Chiari I malformation and delivered in our hospitals over a 50-year period.Main Results12 parturients delivered 30 babies. Three deliveries were facilitated with general anesthesia. Nine deliveries were facilitated with central axis anesthesia, six with epidural anesthesia, two with a single injection of a spinal anesthetic, and one with a continuous spinal catheter. The patient who received a continuous spinal catheter developed a postdural puncture headache that resolved with an epidural blood patch. None of the patients who received general, spinal, or epidural anesthesia for their deliveries developed symptoms or had exacerbation of preexisting symptoms of Chiari I malformation.ConclusionsGeneral anesthesia, as well as spinal and epidural anesthesia, appeared to be safe and effective in our series of vaginal or cesarean delivery patients. The small number of patients in our series does not negate the cautious recommendations of others, but suggests that general anesthesia, as well as spinal or epidural anesthesia, can be used safely and effectively in these patients.

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