2022-01-062022-01-062005-11Özyurt, G. vd. (2005). "Spinal anesthesia in a patient with severe thoracolumbar kyphoscoliosis". Tohoku Journal of Experimental Medicine, 207(3), 239-242.0040-87271349-3329https://doi.org/10.1620/tjem.207.239https://www.jstage.jst.go.jp/article/tjem/207/3/207_3_239/_articlehttp://hdl.handle.net/11452/23896Patients with spine abnormalities, present unique challenges to the health care provider responsible for administrating sedation and anesthesia during surgical and technical procedures. Spinal deformities may cause difficulties with both tracheal intubation and regional anesthesia. This report describes the anesthetic management for two urological operations that were performed in a patient with extremely severe thoracolumbar kyphoscoliosis. After examining the risk factors, spinal block by injecting single dose local anesthetic solution to the intratechal space was chosen to provide anesthesia. It has been suggested that hyperbaric solution, which is of high density compared with cerebrospinal fluid, can safely produce blocks for many operations under spinal anesthesia. In the first procedure, intrathecal injection of 6 mg hyperbaric bupivacaine, a local anesthetic solution (1.2 ml total volume), resulted in inadequate motor and sensory blockade, but the successful motor and sensory blockade at the level of Th10 was achieved in a second attempt with 6.25 mg hypobaric bupivacaine (2 ml). Because of this unexpected effect of local anesthetic solution, in the second operation, the technique was changed to intrathecal injection of 12.5 mg hypobaric bupivacaine (4 ml), and the motor and sensory blockade at Th10 was achieved again. The patient reported satisfactory anesthesia each time, and developed no complications. In conclusion, spinal anesthesia can be successful even in cases of severe thoracolumbar kyphoscoliosis.eninfo:eu-repo/semantics/openAccessGeneral & internal medicineResearch & experimental medicineSpinal anesthesiaThoracolumbar kyphoscoliosisAdjuvants, anesthesiaAdultAnesthesia, spinalAnesthetics, localBupivacaineFentanylHumansKyphosisLithotripsyLumbar vertebraeMaleScoliosisSeverity of illness indexThoracic vertebraeUrinary bladder calculiArticle0002322866000092-s2.0-27744576496239242207316210836Medicine, general & internalMedicine, research & experimentalSpinal Cord Stimulation; Spinal Anesthesia; Complex Regional Pain SyndromesBupivacaineFentanylMarcaine 0.5AdultAnalgesiaAnesthesiological techniquesArticleBladder stoneCase reportDisease severityHumanHyperbarismKyphoscoliosisLithotripsyMaleMotor nerveNerve blockRisk factorSensory nerveSpinal anesthesiaSpine malformationThoracic spineThoracolumbar spine