Volume 26, Issue 121, March 2022

Anaesthetic management of severe dextroscoliosis in a post-covid patient undergoing lumbar fixation and laminectomy

Radhika Bajaj^1♦, Amol Singam², Sanjeev Chaudhary³, Rahul Chaudhary⁴, Parag Dongre⁵

¹Junior Resident, Department of Anaesthesiology, JNMC, AVBRH, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India
²Professor, Department of Anaesthesiology, JNMC, AVBRH, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India
³Chief consultant and director, Chaudhary hospital and postgraduate institute of orthopedics, Nagpur, India
⁴Junior Resident, Department of Orthopedics, JNMC, AVBRH, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India
⁵Senior Resident, Department of Anaesthesiology, JNMC, AVBRH, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India

^♦Corresponding author
Junior Resident, Department of Anaesthesiology, JNMC, AVBRH, Datta Meghe Institute of Medical Sciences, Sawangi, Wardha, Maharashtra, India

ABSTRACT

Aim: Patients who have severe case of kyphoscoliosis face functional and physical difficulties, making anaesthetic treatment challenging. In this example, a severe case of scoliosis was successfully treated under general anaesthesia. The case report aims to highlight the meticulous perioperative management of a patient with severe scoliosis, even after the surgery has been completed. Case: A 69-year-old woman with severe dextroscoliosis, single-vessel disease, and a recent history of covid (1 month ago) was scheduled for L1 to S1 fixation with L2-L4 laminectomy. On post-covid chest x-ray, the patient showed lung fibrosis, making anaesthetic management more challenging. Discussion: Scoliosis can cause a sort of respiratory restriction. The angle of the malformation is connected to the severity of the pulmonary issue. Cardiovascular, respiratory, and neurological dysfunction caused by the abnormality should be assessed prior to surgery. Fluid shift needs to be monitored carefully and corrected if necessary. There were no issues associated to ocular changes or the biracial plexus. Conclusion: Thorough pre-anaesthetic evaluation and optimization of the respiratory and cardiovascular systems is critical. In severe kyphoscoliosis, precise planning of anaesthesia induction and meticulous approach will result in a satisfactory outcome.

Keywords: Scoliosis, COVID, and respiratory insufficiency

Medical Science, 2022, 26, ms97e2108

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DOI: https://doi.org/10.54905/disssi/v26i121/ms97e2108

Published: 11 March 2022