A pregnant woman at 32/40 weeks gestation is rushed into your theatre for a code blue caesarean because of fetal distress. The team tell you that she has been in hospital for the last 6 weeks with Guillain Barre syndrome and has only just got out of ICU where she needed respiratory support for a number of weeks.

What sort of anaesthetic are you going to give? Why is the traditional thio / sux / tube likely to go badly?

If you inject local anaesthetics into her neuraxium what response will you expect from her already damaged nervous system? Will the drugs cause any further damage?

What about breathing and swallowing problems afterwards?

Hi everyone,

This week I am joined by Dr Shilpa Desai, an anaesthetic consultant colleague and we discuss how to handle this rare but tricky group of patients and share a few dodgy dad jokes on the way!

References

https://resources.wfsahq.org/atotw/guillain-barre-syndrome/

Guillain Barre Syndrome - BJA

Cardiac arrest after succinylcholine administration in a pregnant patient recovered from Guillain-Barré syndrome