TY - JOUR
AU - Loughrey, J. P. R.
AB - A 30‐year‐old woman with a history of multiple sclerosis (MS) presented for elective caesarean delivery. Her MS had relapsed during the first trimester with right upper and lower limb sensory deficit, lower limb weakness and difficulty walking necessitating treatment with natalizumab. Her symptoms had resolved by the third trimester. She was referred for anaesthesia assessment prior to her planned caesarean delivery, where she expressed a strong desire to be awake for childbirth.A dural puncture epidural (DPE) was performed for this patient: Following insertion of a Touhy needle into the epidural space at the L4–L5 interspace, a dural puncture was undertaken by needle through needle passage of a 27G pencil‐point spinal needle. Clear cerebrospinal fluid was observed, but no medication was administered through the spinal needle. An epidural catheter was then inserted and test dose of 3 ml bupivacaine 0.5% was administered, followed by 8 ml lidocaine 2% and 8 ml bupivacaine 0.5%. Surgery proceeded after assessment of the block; the patient had no pain during the procedure with adequate sensory and motor blockade. She made an uneventful recovery with no recurrence of neurological symptoms.Epidural anaesthesia has traditionally been favoured for obstetric procedures in patients with MS and is felt to be a 
TI - Dural puncture epidural for caesarean delivery in a parturient with multiple sclerosis
JF - Anaesthesia Reports
DO - 10.1002/anr3.12169
DA - 2022-01-01
UR - https://www.deepdyve.com/lp/wiley/dural-puncture-epidural-for-caesarean-delivery-in-a-parturient-with-tVjgw1S3lv
VL - 10
IS - 1
DP - DeepDyve
ER -