Case Report: Ultrasound Guided Neuraxial Anaesthesia in a Patient with Severe Scoliosis and Large Lumbar Hernia

Background: Use of Ultrasonography (USG) in performing regional blocks is well established. Many anaesthesiologists are still reluctant to use USG to identify landmarks in patients with distorted spinal anatomy. USG is as an effective tool and helps anaesthesiologist to identify various landmark in patients suffering with any kind of spinal deformity. Here we present a case of 52 years old patient posted for Cystoscopy and TURP with a huge right sided lumbar hernia causing spinal deformity. This case report details the problems faced by anaesthesiologist in positioning the patient, difficulty in administering spinal anaesthesia and how difficult spinal anaesthesia was overcome with use of Ultrasound as guide for identifying various anatomical landmarks. Method: This is a case report along with review of literature. Result: Experienced anaesthesiologist can visualize neuraxial structures with satisfactory clarity using USG. A preprocedural scan allows to preview the spinal anatomy, identify midline, locate a given intervertebral level, accurately predict the depth to space, and determine the optimal site and trajectory for needle insertion. Conclusion: Ultrasound guided neuraxial anaesthesia is a rapidly developing alternative to traditional landmark -based techniques with regular usage it can be a resourceful technique in challenging spine cases.