title: ANESTHETIC MANAGEMENT OF FEMORAL FRACTURE REPAIR IN A PATIENT WITH CERVICAL MYELOPATHY, AUTONOMIC DYSFUNCTION, AND DIFFICULT AIRWAY.
abstract: Spinal stenosis is a potentially serious condition that can lead to myelopathies and autonomic instability, both of which, as a result, may complicate anesthetic management. Additionally, neuraxial anesthesia appears to increase the risk of worsened neurological outcomes in this population. A 56-year-old female with spinal stenosis, autonomic dysfunction, and known difficult airway who required anesthesia for repair of a femur fracture is presented. After pre-operative arterial line and femoral block placement, an ultrasound guided subarachnoid block was safely placed. This supports the notion that in the appropriate setting, a safe, successful neuraxial blockade can be performed when a general anesthetic may be fraught with more risk.
authors.forename: Ajay R
authors.initials: AR
authors.lastname: Vellore
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Robards
authors.forename: Steven R
authors.initials: SR
authors.lastname: Clendenen
mesh_terms: D000767:Anesthesia, Epidural / Q000379:methods*; D001342:Autonomic Nervous System Diseases / Q000150:complications*; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D005264:Femoral Fractures / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D013130:Spinal Stenosis / Q000150:complications*; D013346:Subarachnoid Space