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Chloroprocaine 3% for anesthesia during cesarean section in a patient with dopa-responsive dystonia: A case report

Jingxin Zhou¹, Wenqin Zhou, Dong Luo

¹Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education (Sichuan University), Chengdu, China.

|July 5, 2024

Rationale:

Dopa-responsive dystonia (DRD) is a rare autosomal dominant hereditary disorder with a prevalence of 0.5 per million population. The disease is characterized by onset of dystonia in childhood, progressive aggravation of the dystonia with diurnal fluctuation, and complete or near complete alleviation of symptoms with low-dose oral levodopa. The incidence of DRD is low, and only a few publications have described this disorder connected with anesthesia.

Patient Concerns:

We present a case involving a pregnant woman with DRD who continued levodopa/benserazide throughout the pregnancy. The perioperative anesthesia management was described. We used chloroprocaine 3% for epidural anesthesia during cesarean section.

Diagnoses:

Dopa-responsive dystonia.

Interventions:

Levodopa/benserazide.

Outcomes:

In summary, levodopa/benserazide was continued throughout our patient's pregnancy with a good obstetric outcome, and chloroprocaine was safely used in epidural anesthesia without deterioration of her dystonic symptoms.

Lessons:

Chloroprocaine was safely used in epidural anesthesia without deterioration of her dystonic symptoms.

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