Combined spinal and epidural anaesthesia for an elective Caesarean section in a patient with achondroplasia

Abstract

We describe the use of combined spinal and epidural anaesthesia in a 32-year-old parturient with achondroplasia who presented for an elective Caesarean section. A low-dose spinal block, using 5 mg 0.5% hyperbaric bupivacaine with 10 μg fentanyl, was inadequate (sensory loss up to T10). Sensory loss was extended by an epidural bolus of 5 ml 0.5 % isobaric bupivacaine to T6 within 15 minutes for surgery, which lasted 33 minutes. This titratable regional anaesthetic technique proved to be a viable option in the care of this patient.

Keywords: achondroplasia, anaesthesia, regional blocks, combined spinal and epidural anaesthesia

South Afr J Anaesth Analg 2012;18(6):348-350