Continuous spinal anesthesia for hip replacement in an elderly patient with an anterior mediastinal mass: a case report
Rivero, V.; Creagh, O.; Fernández, D.; Hernández, César.; Rivera, A.
Boletin de la Asociacion Medica de Puerto Rico 104(2): 80-81
2012
ISSN/ISBN: 0004-4849 PMID: 23882980 Document Number: 702380
Incremental dosing of intrathecal local anesthetic for an indefinite duration performed during continuous spinal anesthesia (CSA) allows for better control of adverse effects caused by sympathetic nerve blockade. This case report describes a 91-year-old female with a left intertrochanteric fracture and a large thyroid mass causing contralateral anterior displacement of the trachea and the great vessels. We conducted a detailed investigation of the different techniques that can be used in such circumstances and the consequences each may have on a patient. We concluded that: better control of sympathetic nerve blockade and less adverse effects can be achieved with CSA, optimal management of thrombocytopenia should be done in a patient prior to regional anesthesia, and CSA is an anesthetic alternative to consider on elderly patients with an anterior mediastinal mass undergoing hip fracture surgery.