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USG Guided Combined Spinal Epidural: A Boon in an Achondroplasic Dwarf undergoing an Orthopaedic Procedure

Abstract

Divyadarshni Vadivel and Deepa Kane

Achondroplasia is one of the commonest forms of dwarfism. A 26-year-old achondroplasic dwarf with vitamin D deficiency was posted for an elective shaft of femur fixation. Owing to her difficult airway and past history of tuberculosis, it was decided upon to operate her under combined spinal and epidural anaesthesia. This case report highlights on the need for real time ultrasound guidance in locating the epidural space and hence aiding in successful placement of the Quincke’s needle and the epidural catheter. The ultrasound is an effective and reliable tool to ascertain the most feasible inter-vertebral space in cases of a difficult spine anatomy.

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