General anaesthesia for Caesarean section in a parturient with Noonan's syndrome

We describe the anaesthetic management of a parturient with Noonan's syndrome. Her problems included severe cardiac disease, facial abnormalities and extreme phobia to needles. After intrauterine death at 30 weeks' gestation, induction of labour was attempted and extradural analgesia initiated using low-dose bupivacaine. She failed to progress and underwent Caesarean section under general anaesthesia using awake oral fibreoptic intubation.