"please mind the gap": Successful use of ultrasound-assisted spinal anesthesia for urgent cesarean section in a patient with implanted spinal cord stimulation system for giant chest wall arteriovenous malformation - A case report

Bruno Antonio Zanfini, Salvatore De Martino, Luciano Frassanito, Stefano Catarci, Francesco Vitale Di Maio, Pietro Paolo Giuri, Gian Luigi Gonnella, Gaetano Draisci

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The use of Spinal Cord Stimulation (SCS) system to treat medically refractory neuropathic pain is increasing. Severe neuropathic pain can be found in giant chest wall arteriovenous malformations (AVMs), exceedingly rare and debilitating abnormalities, rarely reported during pregnancy. Case presentation: We present a report of a pregnant patient with implanted Spinal Cord Stimulation (SCS) system because of painful thoracic AVM scheduled for an urgent cesarean section in which we used lumbar ultrasound (US) to rule out the possibility to damage SCS electrodes and to find a safe site to perform spinal anesthesia. Conclusions: The use of lumbar US to find a safe site for a lumbar puncture in presence of SCS system in a patient affected by painful thoracic AVM makes this case a particularly unique operative challenge and offers a new possible use of ultrasound to detect a safe space in patients with SCS implant.

Original languageEnglish
Article number122
JournalBMC Anesthesiology
Volume20
Issue number1
DOIs
Publication statusPublished - May 23 2020

Keywords

  • Cesarean section
  • Chest wall arteriovenous malformations
  • Spinal cord stimulation (SCS) system
  • Ultrasound

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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