• Atsuko Shono, Yuji Nakamura, Ayako Goto, Tomoko Kawai, Shinichi Sakura, and Yoji Saito.
• Department of Anesthesiology, Shimane School of Medicine, Izumo.
• Masui. 2007 Jun 1;56(6):692-4.

AbstractOsteogenesis imperfecta (OI) is a rare hereditary disorder characterized by an excessive tendency to bone fractures and retarded growth, as well as variable involvement of other connective tissues such as teeth, sclerae, auditory bones and ligaments. A 30-year-old woman (body mass index of 39.6) with OI was scheduled for appendectomy. Because of obesity, abnormal cervical spine mobility and fragile teeth, in addition to the risk of mandibular and facial fractures, general anesthesia including airway management was considered to be difficult and, thus, avoided. Instead, neuraxial blocks were chosen. Although technical difficulty was expected with the blocks as well, epidural and spinal blocks were successfully performed using image intensifier. Neuraxial blocks for patients with skeletal abnormalities in the lumbar spine such as OI have been considered as relative contraindication. However, as described in this case report, these patients, in whom general anesthesia should be avoided, can benefit from neuraxial blocks with the help of image intensifier.

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