Kardash K, King B W, Datta S
Department of Anesthesia, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115.
Can J Anaesth. 1993 Jul;40(7):667-9. doi: 10.1007/BF03009704.
A case is presented of a 33-yr-old parturient with Harrington fusion of her spine who received spinal anaesthesia with 15 mg hyperbaric bupivacaine for Caesarean delivery. Multiple attempts of needle insertion in both midline and paramedian at the L3-4 interspace were unsuccessful, whereas the procedure was performed uneventfully at the midline of the L5S1 interspace. The anatomical considerations and difficulties in achieving reliable epidural anaesthesia after Harrington fusion are reviewed. Spinal anaesthesia performed at the L5S1 interspace may provide less technical difficulty and a more reliable result in such patients.
本文报告一例33岁接受过脊柱哈林顿融合术的产妇，剖宫产时采用15mg高压布比卡因行脊髓麻醉。在L3-4间隙的中线和旁正中多次尝试穿刺均未成功，而在L5S1间隙中线顺利完成手术。本文回顾了哈林顿融合术后实现可靠硬膜外麻醉的解剖学因素及困难。对于此类患者，在L5S1间隙行脊髓麻醉技术难度可能较小且结果更可靠。
