Continuous Spinal Anaesthesia: Forgotten Technique of Regional Anaesthesia: A Case Report Volume 3 - Issue 2

Bikash Khadka* and Prajjwal Raj Bhattarai

• Department of Anaesthesia and Pain Medicine, Nepal Mediciti, Lalitpur, Nepal

Received: May 13, 2020;  Published: May 22, 2020

Corresponding author: Bikash Khadka, Department of Anaesthesia and Pain Medicine, Nepal Mediciti, Lalitpur, Nepal

DOI: 10.32474/GJAPM.2020.03.000160

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Abstract

Background: Continuous spinal anaesthesia (CSA) is an underutilized technique in modern aesthesia. It allows incremental intermittent dosing of an intrathecal local anaesthetic via an intrathecal catheter which allows titration of block level, block of indefinite duration and better hemodynamic stability than single-shot spinal anaesthesia (SSA). Our aim is to evaluate ease of use, efficacy, and safety of CSA. Case: 91 years male was posted for Right hip resurfacing arthroplasty for right inter trochanteric femur fracture with co morbidity of Squamous cell carcinoma of lungs, CAD with old MI with DCM (EF 15 to 20%) and Heart failure. CSA was used with 0.5ml of 0.5% bupivacaine via intrathecal 20G catheter. Conclusion: Onset was rapid with adequate segmental blockade, better hemodynamic stability, and fewer adverse effects. Lack of exposure among younger anaesthesiologists has made this technique under used though it has low failure rate and is easy to use.

Keywords: Cerebrospinal fluid (CSF); Continuous spinal anaesthesia (CSA); Intrathecal (IT); Local anaesthesia (LA); Post-Dural puncture headache (PDPH); Single-shot spinal anaesthesia (SSA)

Abstract| Introduction| Method| Case Report| Discussion| Conclusion| Financial Support and Sponsorship| Conflicts of Interest| References|