title: Ultrasound-guided spinal anesthesia for cesarean section in a parturient with spinal metastases.
abstract: Preprocedural spinal ultrasound appears to decrease the failure rate and complications of neuraxial anesthesia compared to the conventional landmark technique. It is especially beneficial in difficult cases where conventional palpation technique may fail. We recently encountered a parturient with multiple lumbar and cervical spinal metastatic lesions presenting for cesarean section in the third trimester. We used spinal ultrasound to define the appropriate intervertebral space and measure the distance to the ligamentum flavum-dura mater complex. This greatly helped in administering a safe spinal anesthetic and avoiding general anesthesia which might have been hazardous in this patient.
authors.affiliation: Department of Anesthesia and Surgical Intensive Care, Mansoura University Hospitals, Mansoura, Egypt. m2tawfik@mans.edu.eg.
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: Tawfik
authors.affiliation: Department of Anesthesia and Surgical Intensive Care, Mansoura University Hospitals, Mansoura, Egypt.
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Elrefaey
authors.affiliation: Department of Anesthesia and Surgical Intensive Care, Mansoura University Hospitals, Mansoura, Egypt.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Abdelkhalek
authors.affiliation: Department of Obstetrics and Gynecology, Mansoura University Hospitals, Mansoura, Egypt.
authors.forename: Amany A
authors.initials: AA
authors.lastname: Makroum
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D001859:Bone Neoplasms / Q000473:pathology*; D002585:Cesarean Section; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D009362:Neoplasm Metastasis; D013125:Spinal Neoplasms / Q000473:pathology*; D013131:Spine / Q000503:physiopathology; D018084:Ultrasonography, Interventional
keywords: Cesarean section; Spinal anesthesia; Spinal metastases; Ultrasound