Fractionated Spinal Anaesthesia in an Achondroplastic Dwarf

Abstract

A 57-year-old dwarf with achondroplasia was posted for open reduction and internal fixation with bone grafting of right tibia. He weighed 24 kg and his height was 114 cm. His blood parameters were normal. He had mild thoracic kyphosis. Echocardiography showed a non obstructive hypertrophic cardiomyopathy. Airway was also normal with normal neck movements. The anaesthetic plan was fractionated subarachnoid block (SAB). After obtaining venous access and initiating the standard monitors he was turned to right side and prepared for SAB. A volume of 2.5 mL of hyperbaric 0.5% Bupivacaine was kept ready and SAB was performed with a 25 G Quincke’s needle. The drug was administered in two fractions with an interval of 90 seconds between the two injections....