Real-time ultrasound-guided neuraxial anesthesia for cesarean section in parturients with previous internal fixation surgery for lumbar fracture: a case series

[摘要] Neuraxial anesthesia (i.e., spinal or epidural block) is thepreferred type of anesthesia for cesarean section (CS)worldwide (1-3). Compared with general anesthesia (GA),neuraxial anesthesia may reduce the incidence of maternalairway complications and without potential adverse effectsof general anesthetics on the newborn (4). Currently,GA is used almost exclusively in emergency CS or whenneuraxial anesthesia has failed or is contraindicated (5). Itremains unclear which anesthesia is most appropriate forCS in parturients who have undergone internal fixationsurgery for lumbar fracture. Neuraxial anesthesia is not anabsolute contraindication in these patients (6,7); however,postoperative distortion of the anatomy makes the blocktechnically challenging and may increase the likelihoodof failure, inadvertent dural puncture during epiduralanesthesia, paresthesias, or unpredictable spread of the localanesthetic (8). Nevertheless, neuraxial anesthesia shouldbe considered, as it offers undeniable advantages for CS.To date, there have been only a few case reports on the useof this technique in patients who have undergone internalfixation surgery for lumbar fracture (7,9).

[学科分类] 外科医学