Intravenous remifentanil analgaesia for an obstetric patient with type i neurofibromatosis and a factor v leiden mutation

Abstract EN

Type I neurofibromatosis is characterised by altered skin pigmentation and the growth of benign tumours, particularly along the peripheral nerves and central nervous system.

We report a 36-year-old primigravida woman in labour who was admitted to the obstetric suite of the Hospital Sant Joan de Déu, Barcelona, Spain, in 2007 with hypothyroidism, type I neurofibromatosis and a factor V Leiden mutation.

Due to a lack of cranial and spinal imaging data, an epidural was not indicated; instead, continuous intravenous remifentanil analgaesia was administered.

The remifentanil infusion was self-titrated by the patient using a visual analogue scale, with the dosage ranging from 0.01 to 0.25 μg/kg/minute.

Due to rotational dystocia, Kjelland-type forceps were used during the delivery.

After birth, the infant was found to have Apgar scores of 9 and 10, with no maternal or neonatal adverse effects observed.

Although still controversial, remifentanil may be a successful alternative for analgaesia in similar cases; however, the specific risks and benefits for each patient should be considered prior to administration.