TY - JOUR
T1 - "please mind the gap"
T2 - 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
AU - Zanfini, Bruno Antonio
AU - De Martino, Salvatore
AU - Frassanito, Luciano
AU - Catarci, Stefano
AU - Vitale Di Maio, Francesco
AU - Giuri, Pietro Paolo
AU - Gonnella, Gian Luigi
AU - Draisci, Gaetano
N1 - Publisher Copyright:
© 2020 The Author(s).
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/5/23
Y1 - 2020/5/23
N2 - 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.
AB - 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.
KW - Cesarean section
KW - Chest wall arteriovenous malformations
KW - Spinal cord stimulation (SCS) system
KW - Ultrasound
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U2 - 10.1186/s12871-020-01042-6
DO - 10.1186/s12871-020-01042-6
M3 - Article
C2 - 32446301
AN - SCOPUS:85085380484
VL - 20
JO - BMC Anesthesiology
JF - BMC Anesthesiology
SN - 1471-2253
IS - 1
M1 - 122
ER -