Cesarean section in a patient with syringomyelia

Purpose: To describe the anesthetic management of Cesarean section in a pat ient with syringomyelia. Clinical features: A 27-yr-old pregnant woman with syringomyelia was schedu led to undergo elective Cesarean section, At the age of 25 yr, she had begu n to experience headaches, and at the age of 26 yr, a diagnosis of syringom yelia of the upper spinal cord was made on the basis of magnetic resonance imaging findings. No symptoms other than headache were noted preoperatively . General anesthesia was used for the Cesarean section. After the administr ation of I mg vecuronium as a priming dose, 5 mg vecuronium were injected. At the onset of clinical muscle weakness, 225 mg thiamylal were promptly ad ministered as the induction agent and the patient was intubated (timing pri nciple with priming method) and pressure on the cricoid cartilage applied t o prevent regurgitation of stomach contents. Anesthesia was maintained with oxygen, nitrous oxide and isoflurane at a low concentration. Mild hyperven tilation was used throughout the procedure. Anesthesia and surgery proceede d without any problem, response to vecuronium was clinically normal and rec overy was uneventful. Neurological status remained normal. Conclusion: We report the safe use of general anesthesia for Cesarean secti on in a patient with syringomyelia. Precautions were taken to avoid increas es in intracranial pressure and our patient experienced no untoward neurolo gic event.