Modified ultrasound-guided epidural anesthesia for patients with spine malformation (one case report)

Abstract

Spinal anesthesia keeps the patient′s autonomous respiration, has less influence on cardio-pulmonary function and is suitable for elder people with femoral neck fracture. But it is very difficult and dangerous to complete the epidural anesthesia for patients with spine malformation. In this study, this article described a novel ultrasound-guided technique for epidural access through a para-median transverse scan at the level of articular process, and compared it with the ultrasound-guided long axis scan. Following the in-plane technique under para-median transverse US scanning, this article completed the epidural anesthesia for a patient with spine malformation. This article observed the depth and angle of the spinal needle, the target structure and the structure of adjacent tissue, the diffusion of drugs. The pictures were recorded and stored. Compared with the sagittal scan, the oblique scan is easier to handle. Ultrasound-guided erector spinae plane block is a safe and effective method for spine malformation patients. Key words: Ultrasound-guided; Epidural access; Spine; Malformation; Para-median transverse US scanning