Journal of Anesthesia

, Volume 20, Issue 3, pp 223–226 | Cite as

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

  • Toshiyuki Okutomi
  • Miwako Saito
  • Makiko Koura
  • Sumio Hoka


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 μg 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.

Key words

Continuous intrathecal analgesia Cesarean section Over-the-needle-catheter Scoliosis 


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  1. 1.
    Rogala, EJ, Drummond, DS, Gurr, J 1978Scoliosis: incidence and natural history. A prospective epidemiological studyJ Bone Joint Surg Am60173176PubMedGoogle Scholar
  2. 2.
    Cochran, T, Irstam, L, Nachemson, A 1983Long-term anatomic and functional changes in patients with adolescent idiopathic scoliosis treated by Harrington rod fusionSpine8576584PubMedGoogle Scholar
  3. 3.
    Hubbert, CH 1985Epidural anesthesia in patients with spinal fusionAnesth Analg64843PubMedGoogle Scholar
  4. 4.
    Crosby, ET, Halpern, SH 1989Obstetric epidural anaesthesia in patients with Harrington instrumentationCan J Anaesth36693696PubMedCrossRefGoogle Scholar
  5. 5.
    Daley, MD, Rolbin, SH, Hew, EM, Morningstar, BA, Stewart, JA 1990Epidural anesthesia for obstetrics after spinal surgeryReg Anesth15280284PubMedGoogle Scholar
  6. 6.
    Schachner, SM, Abram, SE 1982Use of two epidural catheters to provide analgesia of unblocked segments in a patient with lumbar disc diseaseAnesthesiology56150151PubMedGoogle Scholar
  7. 7.
    Moran, DH, Johnson, MD 1990Continuous spinal anesthesia with combined hyperbaric and isobaric bupivacaine in a patient with scoliosisAnesth Analg70445447PubMedGoogle Scholar
  8. 8.
    Kardash, K, King, BW, Datta, S 1993Spinal anaesthesia for caesarean section after Harrington instrumentationCan J Anaesth40667669PubMedCrossRefGoogle Scholar
  9. 9.
    Pascoe, HF, Jennings, GS, Marx, GF 1993Successful spinal anesthesia after inadequate epidural block in a parturient with prior surgical correction of scoliosisReg Anesth18191192PubMedGoogle Scholar
  10. 10.
    Stienstra, R, Dahan, A, Alhadi, BZ, van Kleef, JW, Burm, AG 1996Mechanism of action of an epidural top-up in combined spinal epidural anesthesiaAnesth Analg83382386PubMedCrossRefGoogle Scholar
  11. 11.
    Stone, PA, Thorburn, J, Lamb, KS 1989Complications of spinal anaesthesia following extradural block for caesarean sectionBr J Anaesth62335337PubMedGoogle Scholar
  12. 12.
    Beck, GN, Griffiths, AG 1992Failed extradural anaesthesia for caesarean section. Complication of subsequent spinal blockAnaesthesia47690692PubMedGoogle Scholar
  13. 13.
    Hirabayashi, Y, Shimizu, R, Fukuda, H, Saitoh, K, Furuse, M 1995Anatomical configuration of the spinal column in the supine position. II. Comparison of pregnant and non-pregnant womenBr J Anaesth7568PubMedGoogle Scholar
  14. 14.
    Möllman, M, Van Steenberge, A, Sell, A, Pitkänen, M, Holst, D, Van Dongen, A, Berg, S 1996Spinocath, a new approach to continuous spinal anesthesia—preliminary results of a multicenter trialInt Mouitor874Google Scholar
  15. 15.
    Gosch, UW, Hueppe, M, Hallschmid, M, Born, J, Schmucker, P, Meier, T 2005Post-dural puncture in young dults: comparison of two small-gauge spinal catheters with different needle designBr J Anaesth94657661PubMedCrossRefGoogle Scholar

Copyright information

© JSA 2006

Authors and Affiliations

  • Toshiyuki Okutomi
    • 1
  • Miwako Saito
    • 1
  • Makiko Koura
    • 1
  • Sumio Hoka
    • 1
  1. 1.Department of AnesthesiologyKitasato University School of MedicineSagamiharaJapan

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