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EVER LASTING DEBATE : CENTRAL NEURAXIAL BLOCK OR GENERAL ANESTHESIA FOR CESAREAN SECTION IN A PARTURIENT WITH ACUTE VARICELLA
ESRA Academy. Sonthalia N. Sep 8, 2016; 138341
Topic: REGIONAL ANAESTHESIA (RA) IN SPECIFIC SUBPOPULATIONS
Dr. Neha Sonthalia
Dr. Neha Sonthalia

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Abstract
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Background and Aims:

Chicken pox is characterized by fever, malaise and a maculopapular pruritic rash, that is infectious 48 hours before the rash until vesicalisation and crusting are complete. The infection is usually benign in children but can be severe and even fatal in adults due to severe associated complications like myocarditis, bleeding diathesis, meningitis, encephalitis and pneumonitis.

Varicella infection is uncommon in pregnancy. Should infection occur, however, significant maternal, fetal and neonatal effects result. Varicella pneumonitis is particularly serious in pregnancy, with a high maternal mortality rate.

A parturient with varicella (chickenpox) presented for an elective Caesarean section and spinal anesthesia was employed for surgery. My aim is to review the literature and discuss the anesthetic issues.Methods:

I present a Case Report of a 36 weeks pregnant female with chicken pox,  for LSCS, who had multiple risk factors for developing Varicella pneumonia.

There is no evidence  about the optimum method of anesthesia in the literature.  Very few cases have been reported till date. I strive to review the facts and to provide a better understanding of the subject.

Results:

Spinal anesthesia was preferred  in this patient due to the lack of skin lesions at the site of injection, high risk of pneumonitis,  patient consent, and lack of infrastructure.

Conclusions:

The mode of anesthesia for LSCS for a parturient with varicella has to be tailor-made according to the patient. Both spinal and general anesthesia have been used previously. Risks and Benefits must be weighed. 

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