Spinal Anesthetic Considerations In Patients With Vertebral Malformations

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A G2P1 female, with a history of VACTERL Syndrome and multiple spinal operations, presented to L&D for a scheduled Cesarean section. Following spinal block placement, the patient reported numbness to skin pinch at the T10 level. However, following incision, the patient experienced cutting pain on the right abdomen. The OR table was airplaned with the painful side down, and local anesthetic was administered into the wound, allowing for successful completion of the procedure. We will present the differential diagnosis and appropriate management of failed/incomplete spinal anesthetic in patients with previous back surgery undergoing elective, urgent, and emergent Cesarean section.


American Society of Anesthesiology, Anesthesiology 2019. Orlando, FL. October 19-23, 2019.