Clinical implications of neuraxial anesthesia in the parturient with scoliosis

Anesth Analg. 2009 Dec;109(6):1930-4. doi: 10.1213/ANE.0b013e3181bc3584.

Abstract

Scoliosis can pose challenges to the initiation and function of neuraxial anesthetics. We reviewed the available literature exploring neuraxial techniques in parturients with uncorrected or corrected (i.e., surgically instrumented) scoliosis. The 22 articles reported 117 attempted neuraxial procedures (uncorrected n = 24 and corrected n = 93). Of these procedures, 79% of uncorrected patients and 69% of corrected patients were successfully managed with neuraxial anesthesia. Procedures were typically more challenging in corrected patients; 90% of all reported difficulties in this subgroup involved epidural anesthetics. Complications were reported in 3 of 103 patients. We provide suggestions for optimizing efficacy of neuraxial techniques in these patients.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Analgesia, Epidural
  • Analgesia, Obstetrical / methods*
  • Anesthesia, Epidural
  • Anesthesia, Obstetrical / methods*
  • Anesthesia, Spinal
  • Female
  • Humans
  • Labor Pain / complications
  • Labor Pain / drug therapy*
  • Orthopedic Procedures
  • Pain Measurement
  • Pregnancy
  • Radiography
  • Scoliosis / complications*
  • Scoliosis / diagnostic imaging
  • Scoliosis / surgery