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Spinal anaesthesia for Caesarean section after Harrington instrumentation
Authors:Kenneth Kardash  Brian W. King  Sanjay Datta
Affiliation:1. Department of Anesthesia, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, 02115, Boston, Massachusetts
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.
Keywords:  font-variant:small-caps"  >anaesthesia: obstetrical     font-variant:small-caps"  >anaesthetic techniques: spinal     font-variant:small-caps"  >surgery: orthopaedic, Harrington rods     font-variant:small-caps"  >complications: scoliosis
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