Anesthesia for an achondroplastic dwarf presenting for urgent cesarean section

Achondroplasia is a physeal dysplasia which leads to dwarfism secondary to a decrease in the proliferation of cartilage in the growth plate. This, coupled with normal persistent bone formation, leads to the development of short tubular bones. Achondroplastic dwarfism is among the more common types of dwarfism and is inherited as an autosomal dominant trait. Its incidence is reported as 1 in 26,000 live births. Most achondroplastic dwarfs have a normal life span. The selection and management of anesthesia for the achondroplastic dwarf must take into account a variety of anatomic deformities. The physiologic and hormonal changes of pregnancy further complicate anesthetic administration. We report the safe use of a continuous lumbar epidural anesthetic in an achondroplastic dwarf who presented for urgent cesarean section.