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Canadian Journal of Anesthesia 52:967-970 (2005)
© Canadian Anesthesiologists' Society, 2005
Obstetrical and Pediatric Anesthesia

Anesthetic management of the parturient with relapsing polychondritis

[Anesthésie d’une parturiente atteinte de polychondrite chronique atrophiante]

M. Joanne Douglas, MD FRCPC and Stephanie Ensworth, MD FRCPC

From the Departments of Anesthesia and Medicine, Division of Rheumatology, B.C. Women’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada.

Address correspondence to: Dr. Joanne Douglas, Department of Anesthesia, B.C. Women’s Hospital, 4500 Oak Street, Vancouver, B.C. V6H 3N1, Canada. Phone: 604-875-2158; Fax: 604-875-2733; E-mail: jdouglas{at}cw.bc.ca

Purpose: To present the anesthetic management of a parturient with relapsing polychondritis (RP) and to discuss the anesthetic implications of RP.

Clinical features: A 28-yr-old primiparous woman with known RP, spondyloarthropathy and fibromyalgia presented for urgent Cesarean delivery for breech presentation and prodromal labour. Her pregnancy had been complicated by a hospital admission for an exacerbation of her RP as manifested by hoarseness, increased pain and tenderness of her left ear and nasal bridge cartilages, sinusitis with bloody nasal discharge and increased pain and tenderness of the anterior tracheal rings. Epidural anesthesia was administered for the Cesarean delivery. Her intraoperative and postoperative course was uneventful. Close cooperation among obstetricians, anesthesiologists and rheumatologists resulted in a successful outcome.

Conclusion: Relapsing polychondritis is a syndrome with important anesthetic implications. Multidisciplinary cooperation is essential in managing these high risk parturients.






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Copyright © 2005 by the Canadian Anesthesiologists' Society.