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Canadian Journal of Anaesthesia

, Volume 40, Issue 7, pp 667–669 | Cite as

Spinal anaesthesia for Caesarean section after Harrington instrumentation

  • Kenneth Kardash
  • Brian W. King
  • Sanjay Datta
Clinical Reports

Abstract

A case is presented of a 33-yr-old parturient with Harrington fusion of her spine who received spinal anaesthesia with 15 mg hyperbaric bupivacaine for Caesarean delivery. Multiple attempts of needle insertion in both midline and paramedian at the L3-4 interspace were unsuccessful, whereas the procedure was performed uneventfully at the midline of the L5S1 interspace. The anatomical considerations and difficulties in achieving reliable epidural anaesthesia after Harrington fusion are reviewed. Spinal anaesthesia performed at the L5S1 interspace may provide less technical difficulty and a more reliable result in such patients.

Key words

anaesthesia: obstetrical anaesthetic techniques: spinal surgery: orthopaedic, Harrington rods complications: scoliosis 

Résumé

Il s’agit d’une parturiente de 33 ans déjà opérée d’une fusion vertébrale de Harrington et qui reçoit une anesthésie rachidienne avec 15 mg de bupivacaine hyperbare pour une césarienne. Des tentatives multiples de ponction médiane et paramédiane dans l’espace L3-L4 ont échoué. Les considérations anatomiques et les difficultés pour réaliser une anesthésie épiduraie fiable après une fusion de Harrington sont revues. L’anesthésie rachidienne réalisée à l’espace L5-S1 peut présenter moins de difficultés techniques et un résultat plus fiable chez de telles patientes.

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Copyright information

© Canadian Anesthesiologists 1993

Authors and Affiliations

  • Kenneth Kardash
    • 1
  • Brian W. King
    • 1
  • Sanjay Datta
    • 1
  1. 1.Department of AnesthesiaBrigham and Women’s Hospital, Harvard Medical SchoolBoston

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