# Friedreich’s Ataxia and Cesarean Delivery: A Case Report of Epidural Anesthesia With Ropivacaine

## TL;DR

A woman with Friedreich’s ataxia successfully underwent cesarean delivery with epidural anesthesia using ropivacaine, with stable vital signs and no worsening of neurological symptoms.

## Contribution

This case report provides insights into the safe use of epidural anesthesia in a patient with Friedreich’s ataxia during cesarean delivery.

## Key findings

- Epidural anesthesia with ropivacaine at L2-L3 was effective and safe for a patient with Friedreich’s ataxia during cesarean delivery.
- No hypotension, bradycardia, or need for vasoactive drugs occurred during the procedure.
- The patient reported no change in neurological symptoms post-discharge.

## Abstract

Friedreich’s ataxia (FRDA), a rare inherited neurodegenerative disease, presents distinctive complexities in obstetrical anesthesia. Available research about FRDA in obstetrics is extremely limited. In this report, the anesthetic management of a 40-year-old primigravida with FRDA undergoing cesarean delivery is presented. An uneventful cesarean delivery with effective epidural anesthesia with ropivacaine at the L2-L3 intervertebral space was performed in our case. Neither hypotension nor bradycardia was observed, and vital signs remained stable, with no need for administration of vasoactive drugs. After discharge, the parturient reported no change in her neurologic symptoms. Conclusive recommendations are contingent upon more extensive studies. Overall management and the choice to proceed with neuraxial anesthesia in a woman with FRDA should be based on comprehensive consultations in both cardio-obstetrics and pre-anesthetic evaluations.