Anesthetic considerations in a parturient with Freeman-Sheldon syndrome

Area of Science:

• Anesthesiology
• Medical Genetics
• Obstetrics

Background:

• Freeman-Sheldon syndrome is a rare genetic disorder impacting craniofacial and musculoskeletal development.
• Patients may present with complex medical histories, including spinal deformities and cardiac devices.

Observation:

• This case report focuses on the anesthetic management of a pregnant patient with Freeman-Sheldon syndrome undergoing cesarean delivery.
• The patient had a history of kyphoscoliosis and a cardiac pacemaker, indicating a high-risk surgical profile.

Findings:

• A combined spinal-epidural anesthetic technique was chosen due to a predicted difficult airway.
• Challenges encountered included difficulty establishing intravenous access and identifying the subarachnoid space, alongside patient discomfort during the procedure.

Implications:

• This case highlights the importance of meticulous pre-anesthetic evaluation and planning in patients with rare genetic syndromes.
• Careful technique and preparedness are crucial for managing potential complications during anesthesia for cesarean delivery in high-risk patients.