Spinal anesthesia using a continuous spinal catheter for cesarean section in a parturient with prior surgical correction of scoliosis

Abstract

This case report demonstrates the successful anesthetic management of cesarean section for a 29-year-old primiparous parturient with a past history of a scoliosis operation at 13 years of age. An Isola hook and screw-rod system had been implanted as posterior spinal instrumentation at the level of T3-L3. We titrated hyperbaric bupivacaine 7 mg combined with fentanyl 15 microg through a continuous spinal catheter, placed with a catheter-over-needle technique in order to avoid unintentional wide spread of anesthetic agents. The anesthetic level was T4 at the start of the operation. Her surgery was carried out without any problems. Headache, as a dural tap-related complication, was not observed. Spinal anesthesia with the titration of anesthetic agents for cesarean section is considered to be one of the choices for a parturient who has had spinal instrumentation.

Observational study of continuous spinal anesthesia with the catheter-over-needle technique for cesarean delivery

“…1 The majority of the scientific publications on CSA in obstetrics are case reports of patients with heart disease or other medical disorders. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] There are few studies in the literature assessing the efficacy and safety of CSA in obstetrics, whether descriptive or comparative studies. [22][23][24][25][26] The primary objective of this study was to assess the efficacy and safety of CSA with the catheter-overneedle technique (Spinocath Ò ) when used for elective cesarean delivery.…”

Ultrasound-guided continuous spinal anesthesia for cesarean section in a parturient with scoliosis corrected with harrington's rod surgery

“…[13] CSA remains the most commonly used RA technique for CS in patients with surgically corrected scoliosis. [31516] CSA offers the ability to establish the block gradually (avoiding hypotension), use of additional dose (avoiding patchy or inadequate block), and avoidance of ADP. Nonetheless, performing of CSA in such patients remains technically challenging.…”

Can general anesthesia for cesarean delivery be completely avoided? An anesthetic perspective

“…When compared with a conventional epidural technique, the CSE technique also has a lower risk of epidural catheter failure [40]. Continuous spinal anesthesia with a macro (19 or 20 G) epidural catheter is a viable option when other options fail, or when an inadvertent dural puncture occurs during an intended epidural technique [41].…”