Anaesthesia without induction rooms.
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Biomedical subjects
Publications and source records attributed to J W Broadway.
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Patients with dystrophia myotonica requiring caesarean section pose significant problems for the anaesthetist. This report describes the successful use of a combined spinal-epidural technique for anaesthesia and postoperative analgesia in such a patient.
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We have used both spinal and extradural anaesthesia with a 26-gauge, long spinal needle through a 16-gauge Tuohy needle for elective Caesarean section. Four different subarachnoid solutions of bupivacaine were compared: 0.5% heavy bupivacaine alone, or with adrenaline, fentanyl or adrenaline and fentanyl. The incidence of complications and time of regression of the sensory block were analysed. The technique is recommended because it allows rapid onset of anaesthesia and the advantages of an extradural catheter. The subarachnoid solution of choice was 0.5% heavy bupivacaine 12.5 mg with fentanyl 10 micrograms.
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