PulseExploreJournal ClubResearchersJournals
Instagram
HomeJournal ClubExplore
Synapse
⌘+K
Synapse
September 3, 2026BMJ Case Reports

Awake emergency laparotomy under combined spinal epidural anaesthesia in a high-risk patient with severe pulmonary disease and neuromuscular blocking agent anaphylaxis

View Full Paper
Ask AI
Bookmark
Share

Authors

SKShikshya KhatiwodaSASatya Durga Anantapatnaikuni

Discussion

Loading...

Member takes

Overview

Case report reveals successful awake emergency laparotomy under combined spinal-epidural anaesthesia in severe lung disease, indicating neuraxial techniques can circumvent general anaesthesia.

Key Points

  • To describe the successful application of awake combined spinal-epidural anaesthesia for emergency laparotomy in an elderly patient with severe respiratory disease and neuromuscular blocking agent anaphylaxis.
  • Conducted an emergency laparotomy for bowel obstruction in a frail elderly patient with severe chronic obstructive pulmonary disease and documented life-threatening hypersensitivity to multiple neuromuscular blocking agents.
  • Administered regional anaesthesia using a needle-through-needle combined spinal-epidural anaesthesia technique as the sole anaesthetic method without general anaesthesia.
  • Emergency abdominal surgery was completed successfully without the need for airway instrumentation or conversion to general anaesthesia.
  • The patient experienced an uncomplicated perioperative course with no hypersensitivity reactions or postoperative respiratory compromise.

Cite This Study

Khatiwoda et al. (2026) studied this question.

synapsesocial.com/papers/6a993547636c6408cfa7d607https://doi.org/10.1136/bcr-2025-269157
View Full Paper
Ask AI
Bookmark
Share