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Open Access 01-12-2020 | Neuropathic Pain | Case report

“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

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

Published in: BMC Anesthesiology | Issue 1/2020

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.

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Title: “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
Authors: Bruno Antonio Zanfini
Salvatore De Martino
Luciano Frassanito
Stefano Catarci
Francesco Vitale di Maio
Pietro Paolo Giuri
Gian Luigi Gonnella
Gaetano Draisci
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Neuropathic Pain
Ultrasound
Complex Regional Pain Syndrome
Spinal Anesthesia
Spinal Cord Stimulation
Complex Regional Pain Syndrome
Sectio Ceasarea
Ultrasound
Sectio Caesarea
Arteriovenous Malformation
Published in: BMC Anesthesiology / Issue 1/2020
Electronic ISSN: 1471-2253
DOI: https://doi.org/10.1186/s12871-020-01042-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

“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

Abstract

Background

Case presentation

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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