Patient-controlled epidural analgesia for labor and delivery in a parturient with chronic inflammatory demyelinating polyneuropathy.

Abstract

The anesthetic management of labor and delivery in patients with any form of chronic inflammatory demyelinating polyneuropathy (CIDP) is not well defined. Using patient-controlled epidural analgesia (PCEA), or epidural analgesia, in such a rare clinical situation has not been previously reported. A 32-year-old, gravida 3, para 2, woman with a 2(1/2) year history of CIDP was admitted for labor and delivery at 38 weeks of pregnancy. At the time she presented for labor analgesia, she complained of bilateral hand and foot weakness and tingling. PCEA with 0.1% ropivacaine and fentanyl 2 microg/mL was used for labor analgesia. The patient was pain free during labor and delivery and had an uneventful postpartum course. PCEA had no apparent detrimental affect on the patient's disease and may be a reasonable option for patients with CIDP presenting for labor and delivery.