Thoracic spinal anaesthesia for paediatric upper extremity surgery in limited-resource hospital: a case report

Prima, Agus; Hamdi, Tasrif; Sitepu, John Frans; Ghozali, Imam; Lubis, Asmin

doi:10.1186/s42077-023-00369-9

Thoracic spinal anaesthesia for paediatric upper extremity surgery in limited-resource hospital: a case report

Authors

10.1186/s42077-023-00369-9

Abstract

Background
Thoracic spinal anaesthesia for upper extremity surgery is rarely performed and exceptional procedure. We report a case in which thoracic spinal anaesthesia (T3–T4 intervertebral space) was performed successfully in a paediatric patient with distal radius fracture ORIF surgery.
Case presentation
A 15 years old man with distal radius fracture ORIF was scheduled to undergo remove of implant. His parents did not want to have general anaesthesia because complication of postoperative pulmonary complications, patient has allergy and asthmatic potential. We proposed thoracic spinal anaesthesia with small dose bupivacaine 0.5% hyperbaric (5 mg).
Conclusions
Thoracic spinal anaesthesia with small dose bupivacaine 0.5% hyperbaric at the cervical level (C4) may offer an alternative option when general anaesthesia or conventional regional techniques are contraindicated or equipment unavailable to perform peripheral nerve block.

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