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Canadian Journal of Anesthesia, Vol 43, 1052-1058, Copyright © 1996 by Canadian Anesthesiologists' Society

ARTICLES

Spinal anaesthesia for Caesarean section in a patient with a cervical arteriovenous malformation

BY Ong, J Littleford, R Segstro, D Paetkau and I Sutton
Department of Anesthesia, University of Manitoba, Winnipeg, Canada.

PURPOSE: Arteriovenous malformations (AVM) of the spinal cord are rare. We report the successful management of a patient with a cervical spinal cord AVM undergoing Caesarean section delivery, using a spinal anaesthetic. CLINICAL FEATURES: Based on previous radiological investigations, the patient was known to have an AVM at the third cervical level of her spinal cord. After application of monitors and intravenous administration of 1 L normal saline, a 25 g Whitacre needle was inserted into the subarachnoid space at the L3-4 interspace. Spinal anaesthesia was established with a solution consisting of hyperbaric spinal bupivacaine 12 mg, fentanyl 12.5 micrograms and epidural morphine 0.25 mg. There was no neurological deficit during hospital stay or after discharge. CONCLUSION: The safe outcome of spinal anaesthesia for our patient is encouraging. The presence of spinal cord AVM at the cervical region is not an absolute contraindication to spinal anaesthesia.




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Copyright © 1996 by the Canadian Anesthesiologists' Society.