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- Ki Jinn Chin, Alan J R Macfarlane, Vincent Chan, and Richard Brull.
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Ontario, Canada.
- J Clin Ultrasound. 2009 Oct 1;37(8):482-5.
AbstractWe describe a case of ultrasound (US)-facilitated spinal anesthesia in a patient with a prior lumbar laminectomy and spinal fusion who presented for total knee arthroplasty. Traditional, landmark-guided spinal anesthesia had previously failed. Although pre-procedural US identified a soft-tissue window at L3/4, a 25G pencilpoint needle encountered resistance. Reassured from US imaging that this was not bone, we used a 22G cutting tip needle successfully. We believe spinal anesthesia would not have been possible in this patient without US, adding to the evidence that US-facilitated neuraxial anesthesia is useful, particularly in technically difficult, if not 'impossible,' cases.
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