Successful Spinal Anesthesia in a Case of Achondroplastic Parturient for Cesarean Section: Case Report

Achondroplastic pregnant patients almost invariably lead to caesarean section due to cephalo-pelvic disproportion. We report a twenty year old short stature primigravida in labour taken for elective caesarean section for cephalopelvic disproportion. On physical examination she was short statured with height of 110 cm and weight of 37 kg. She had large head with frontal bossing and short limb. Examination of spine showed reduced intervertebral space. All clinical examinations were supportive of a diagnosis of Achondroplasia. Spinal anaesthesia was planned. 25G quinke spinal needle was inserted in L4-L5 subarachnoid space with paramedian approach successfully in second attempt. Local anesthetic bupivacaine and fentanyl were given intrathecally. Adequate motor and sensory blockade achieved and surgery went uneventful. Patient was stable intra and post-operatively.