Anesthesia for Emergency Cesarean Section in a Parturient with Noonan

Patients with Noonan syndrome are characterized by many anesthetic problems, primarily related to potential difficult airway and technical issues with regional anesthesia. We describe the anesthetic management of a difficult case of a parturient with Noonan syndrome requiring emergency Cesarean section under spinal anesthesia. We had to evaluate the patient within a limited amount of time because of fetal distress. Although spinal injection was easily accomplished, it resulted in inadequate sensory block requiring supplemental analgesics and sedatives.