Childbirth with epidural analgesia in a pregnant woman with hypokalemic periodic paralysis.

Abstract

Familial hypokalaemic periodic paralysis (FHPP) is an uncommon genetic disease characterized by muscle weakness associated with hypokalaemia. Episodes are precipitated by drugs, stress, metabolic diseases, hypothermia or infection. We report the case of a 38-year-old pregnant women with FHPP who underwent epidural analgesia for labour. Pregnant women with FHPP require multidisciplinary management involving an anaesthesiologist, a gynaecologist and a paediatrician. It is important to maintain normothermia, prevent hyperventilation, monitor electrolytes, avoid glucose infusions and medications that cause hypokalaemia, and administer potassium supplements when required. Locoregional techniques should be preferred over general anaesthesia. Early epidural analgesia reduces the risk of pain that could trigger an episode of FHPP. In the case of general anaesthesia, drugs that can cause malignant hyperthermia should be avoided, and short-acting non-depolarizing neuromuscular blockers with blockade-depth monitoring should be used.

• Authors: J Talaván Serna, L Belmonte Bayo, L Gil Melgosa, F Murciano García, S Rodríguez Martínez
• Journal: Revista espanola de anestesiologia y reanimacion (Rev Esp Anestesiol Reanim (Engl Ed)) 2022 Jun-Jul Vol. 69 Issue 6 Pg. 360-363 ISSN: 2341-1929 [Electronic] Spain
• PMID: 35753928 (Publication Type: Case Reports)
• Copyright: Copyright © 2021 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Topics

• Adult
• Analgesia, Epidural
• Delivery, Obstetric
• Female
• Humans
• Hypokalemia (complications)
• Hypokalemic Periodic Paralysis (complications, genetics)
• Pregnancy
• Pregnant Women