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Int J Obstet Anesth · Jul 2013
Case ReportsSpinal anaesthesia for caesarean section in the presence of respiratory failure and spinal metastases from a soft tissue clear cell sarcoma.
- D P Dob and A M Miskovic.
- Magill Department of Anaesthesia, Chelsea and Westminster Hospital, London, UK. aliceshorthouse@doctors.org.uk
- Int J Obstet Anesth. 2013 Jul 1;22(3):247-50.
AbstractSpinal metastases occur in up to 70% of all patients with cancer. However, only 10% are symptomatic. Before considering central neuraxial blockade in patients with malignancy, a history of back pain should be excluded. Anaesthetists should be aware that intrathecal and epidural injections could cause paraplegia if metastases are impinging on the spinal cord. Failure to achieve adequate sensory anaesthesia after central neuraxial blockade or presentation with postoperative paraplegia may indicate the presence of asymptomatic vertebral canal metastases. In this report, the anaesthetic management of a patient with respiratory failure and spinal metastases from a soft tissue sarcoma, requiring caesarean section is described. Sensory anaesthesia extending above a level of imminent cord compression was achieved despite loss of cerebrospinal fluid signal on magnetic resonance imaging.Copyright © 2013 Elsevier Ltd. All rights reserved.
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