Two cases of thoracic spinal anaesthesia in patients with severe diseases

Publication date: Available online 8 May 2015 Source:Egyptian Journal of Anaesthesia Author(s): Adriano Bechara de Souza Hobaika , Cáudia Helena Ribeiro Silva , Nilo Garonci Alves , Wirleide Matos Leão , Núbia Campos Faria Isoni This manuscript describes two cases of thoracic spinal anaesthesia for patients with severe diseases, with satisfying results. Patient 1: female, 57years old, submitted to a surgical gastrostomy. She had squamous cell carcinoma of the hypopharynx involving the C6 vertebra, carotid and thyroid, with a fistula in the cervical region. After sedation, an epidural puncture was performed in the T7–T8 interspace and an epidural catheter was introduced. Then, a 25G Quinke needle was introduced 5.4cm in the subarachnoid T8–T9 interspace and 5.0mg of isobaric bupivacaine was administered. The dermatome level of anaesthesia was established from T3 to T12, preserving the movement of lower limbs. Patient 2: male, 41years old, with alcohol-related brain atrophy, progressive strength loss in both lower and upper limbs, with spastic tetraparesis and tetrahyperreflexia. After sedation, a 25G Quinke needle was introduced in the subarachnoid T8–T9 interspace, and 5.0mg of isobaric bupivacaine was introduced. Both patients were transferred to the post-anaesthesia recovery room. The greatest cause for concern in the administration of spinal anaesthesia is the possibility of an accidental medullary puncture. In a recent study, it was found a larger distan...
Source: Egyptian Journal of Anaesthesia - Category: Anesthesiology Source Type: research