Use of ultrasound for spinal anesthesia in a super morbidly obese patient.

We report the application of ultrasound prescans for spinal anesthesia to morbid obesity patient. A 38-year-old woman with a body mass index (BMI) of 50 (weight: 110 kg; height: 148 cm) was scheduled to undergo pilonidal cyst resection at the bottom of the tailbone. Spinal anesthesia was selected for the procedure, because the patient's position during the surgery was prone and the patient had morbid obesity. To determine the spinal needle insertion point and the distance between the skin and dura, we planned to use ultrasound. The transverse view of the patient's lumbar spine showed the posterior dura, transverse process, and posterior vertebral body below the thick fat tissue. At this point, spinal anesthesia was successfully performed. Pre-insertion ultrasound guidance for spinal anesthesia was useful in this morbidly obese patient with a BMI of 50.