Ultrasound-guided epidural anesthesia for a parturient with severe malformations of the skeletal system undergoing cesarean delivery: a case report

• DOI: 10.2147/lra.s81696
• Publication Date: 2015-05-14T23:55:33Z
• Authors: Linli Luo; Juan Ni; Lan Wu; Dong Luo
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Anesthesiology; RD78.3-87.3; Case Report; Local and Regional Anesthesia; 3. Good health

Anesthetic management of patients with preexisting diseases is challenging and individualized approaches need to be determined based on patients’ complications. We report here a case of ultrasound-guided epidural anesthesia in combination with low-dose ketamine during cesarean delivery on a parturient with severe malformations of the skeletal system and airway problems. The ultrasound-guided epidural anesthesia was performed in the L1–L2 space, followed by an intravenous administration of ketamine (0.5 mg/kg) for sedation and analgesia. Satisfactory anesthesia was provided to the patient and spontaneous ventilation was maintained during the surgery. The mother and the baby were discharged 5 days after surgery, no complications were reported for either of them. Our work demonstrated that an ultrasound-guided epidural anesthesia combined with low-dose ketamine can be used to successfully maintain spontaneous ventilation and provide effective analgesia during surgery and reduce the risk of postoperative anesthesia-related pulmonary infection.