Anesthetic considerations for the parturient with neurofibromatosis type 1

Abstract

Neurofibromatosis type 1 (NF1) is a relative common genetic disorder affecting multiple major organ systems throughout the body like the central nervous system, cardiovascular system and respiratory system. As life expectancy extends beyond the childbearing years, an anaesthetist may come into contact with a pregnant woman with neurofibromatosis. The aim of this narrative review is to examine the current literature on how to safely anaesthetise the parturient with NF1 and highlight any difficulties that may be encountered. We reviewed two major databases up to May 2023. We conclude that patients with NF1 require a thorough preoperative assessment early in pregnancy, with particular attention to airway management, causes of hypertension and the presence of neuraxial disease involvement. An individual plan for anaesthesia needs to be made based on personal history and symptoms. Currently there is insufficient evidence to provide clear guidelines on the safe use of neuraxial anaesthesia in the NF1 population.