Childbirth with epidural analgesia in a pregnant woman with hypokalemic periodic paralysis.

Familial hypokalaemic periodic paralysis (FHPP) is an uncommon genetic disease characterized by muscle weakness associated with hypokalaemia. Episodes are precipitated by drugs, stress, metabolic diseases, hypothermia or infection. We report the case of a 38-year-old pregnant women with FHPP who underwent epidural analgesia for labour. Pregnant women with FHPP require multidisciplinary management involving an anaesthesiologist, a gynaecologist and a paediatrician. It is important to maintain normothermia, prevent hyperventilation, monitor electrolytes, avoid glucose infusions and medications that cause hypokalaemia, and administer potassium supplements when required. Locoregional techniques should be preferred over general anaesthesia. Early epidural analgesia reduces the risk of pain that could trigger an episode of FHPP. In the case of general anaesthesia, drugs that can cause malignant hyperthermia should be avoided, and short-acting non-depolarizing neuromuscular blockers with blockade-depth monitoring should be used.

Parto con analgesia epidural en una gestante con parálisis periódica hipocaliémica / Childbirth with epidural analgesia in a pregnant woman with hypokalemic periodic paralysis

La parálisis hipocaliémica periódica familiar (PHPF) es una rara entidad genética que causa episodios de debilidad muscular con hipopotasemia precipitados por fármacos, estrés, alteraciones metabólicas, hipotermia o infecciones. En este artículo se describe el caso de una gestante de 38 años con PHPF en periodo activo de parto con evolución favorable con analgesia epidural. La PHPF en la gestante requiere un manejo multidisciplinar entre anestesia, ginecología y pediatría. Está indicado mantener la normotermia, prevenir la hiperventilación, monitorizar los iones en sangre, evitar las soluciones glucosadas y las medicaciones que produzcan descensos de la calcemia, aportando suplementos de potasio cuando se precise. Se prefieren las técnicas locorregionales a la anestesia general, siendo conveniente la analgesia epidural precoz en el parto para reducir el riesgo de crisis precipitadas por el dolor. En la anestesia general conviene evitar fármacos precipitantes de la hipertermia maligna y utilizar BNMND de acción corta con monitorización neuromuscular.(AU)

Familial hypokalaemic periodic paralysis (FHPP) is an uncommon genetic disease characterized by muscle weakness associated with hypokalaemia. Episodes are precipitated by drugs, stress, metabolic diseases, hypothermia or infection. We report the case of a 38-year-old pregnant women with FHPP who underwent epidural analgesia for labour. Pregnant women with FHPP require multidisciplinary management involving an anaesthesiologist, a gynaecologist and a paediatrician. It is important to maintain normothermia, prevent hyperventilation, monitor electrolytes, avoid glucose infusions and medications that cause hypokalaemia, and administer potassium supplements when required. Locoregional techniques should be preferred over general anaesthesia. Early epidural analgesia reduces the risk of pain that could trigger an episode of FHPP. In the case of general anaesthesia, drugs that can cause malignant hyperthermia should be avoided, and short-acting non-depolarizing neuromuscular blockers with blockade-depth monitoring should be used.(AU)

Childbirth with epidural analgesia in a pregnant woman with hypokalemic periodic paralysis. / Parto con analgesia epidural en una gestante con parálisis periódica hipocaliémica.

Familial hypokalaemic periodic paralysis (FHPP) is an uncommon genetic disease characterized by muscle weakness associated with hypokalaemia. Episodes are precipitated by drugs, stress, metabolic diseases, hypothermia or infection. We report the case of a 38-year-old pregnant women with FHPP who underwent epidural analgesia for labour. Pregnant women with FHPP require multidisciplinary management involving an anaesthesiologist, a gynaecologist and a paediatrician. It is important to maintain normothermia, prevent hyperventilation, monitor electrolytes, avoid glucose infusions and medications that cause hypokalaemia, and administer potassium supplements when required. Locoregional techniques should be preferred over general anaesthesia. Early epidural analgesia reduces the risk of pain that could trigger an episode of FHPP. In the case of general anaesthesia, drugs that can cause malignant hyperthermia should be avoided, and short-acting non-depolarizing neuromuscular blockers with blockade-depth monitoring should be used.

Tratamiento anestésico en el síndrome de Kearns-Sayre. Descripción de un caso / Anesthetic management of Kearns-Sayre syndrome. Case report

El síndrome de Kearns-Sayre constituye una miopatía mitocondrial que cursa con oftalmoplejia, retinopatía pigmentaria y alteraciones de la conducción cardiaca. Presentamos el caso de un paciente de 50 años de edad con síndrome de Kearns-Sayre intervenido de una fractura de fémur con anestesia subaracnoidea.(AU)

Kearns-Sayre syndrome is a mitochondrial myopathy characterized by ophthalmoplegia, pigmentary retinopathy and cardiac conduction abnormalities. This article describes the clinical management of a 50-year-old patient with Kearns-Sayre syndrome who underwent subarachnoid anesthesia for a traumatic femoral fracture surgery.(AU)

Anesthetic management of Kearns-Sayre syndrome. Case report. / Tratamiento anestésico en el síndrome de Kearns-Sayre. Descripción de un caso.

Kearns-Sayre syndrome is a mitochondrial myopathy characterized by ophthalmoplegia, pigmentary retinopathy and cardiac conduction abnormalities. This article describes the clinical management of a 50-year-old patient with Kearns-Sayre syndrome who underwent subarachnoid anesthesia for a traumatic femoral fracture surgery.