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Taylor's approach in an ankylosing spondylitis patient posted for percutaneous nephrolithotomy: A challenge for anesthesiologists.

Jindal P, Chopra G, Chaudhary A, Rizvi AA, Sharma JP - Saudi J Anaesth (2009)

Bottom Line: Fiberoptic bronchoscopy was attempted, but without success.This resulted in adequate sensory and motor blockade for the surgical procedure.The patient did not require airway interventions, but equipment and aids to secure airway were available.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Intensive Care and Pain Management, Himalayan Institute of Medical Sciences, Dehradun, Uttaranchal, India.

ABSTRACT
We describe a patient with long-standing ankylosing spondylitis who underwent percutaneous nephrolithotomy under spinal anesthesia. At preoperative assessment, it was considered that intubation of the trachea was likely to be difficult. Fiberoptic bronchoscopy was attempted, but without success. As the standard technique for spinal anesthesia failed, a variation of the paramedian approach in the lumbosacral approach, also known as Taylor's approach was successfully attempted. This resulted in adequate sensory and motor blockade for the surgical procedure. The patient did not require airway interventions, but equipment and aids to secure airway were available.

No MeSH data available.


Related in: MedlinePlus

Diagrammatic presentation of Taylor's approach (reproduced from Batra M, Mulroy M, Neal J. Atlas of Anesthesia: Principles of Anesthetic Techniques and Anesthetic Emergencies)
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Figure 0002: Diagrammatic presentation of Taylor's approach (reproduced from Batra M, Mulroy M, Neal J. Atlas of Anesthesia: Principles of Anesthetic Techniques and Anesthetic Emergencies)

Mentions: In this case spinal anesthesia was considered, after unsuccessful attempts to establish the airway. As we failed to perform a subarachnoid block by the standard midline approach, due to anatomical/technical difficulties, we attempted the Taylor's approach [Figure 2], which is a modification of the paramedian approach for spinal anesthesia. It has all the advantages of the paramedian approach and also it is carried out at the L5-S1 interspace, the largest interlaminar space of the vertebral column. A spinal needle is inserted in a cephalomedial direction through a skin wheal raised 1 cm medial and 1 cm caudad to the lowermost prominence of the posterosuperior iliac spine.[1415] We succeeded by this approach in the first attempt.


Taylor's approach in an ankylosing spondylitis patient posted for percutaneous nephrolithotomy: A challenge for anesthesiologists.

Jindal P, Chopra G, Chaudhary A, Rizvi AA, Sharma JP - Saudi J Anaesth (2009)

Diagrammatic presentation of Taylor's approach (reproduced from Batra M, Mulroy M, Neal J. Atlas of Anesthesia: Principles of Anesthetic Techniques and Anesthetic Emergencies)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2876933&req=5

Figure 0002: Diagrammatic presentation of Taylor's approach (reproduced from Batra M, Mulroy M, Neal J. Atlas of Anesthesia: Principles of Anesthetic Techniques and Anesthetic Emergencies)
Mentions: In this case spinal anesthesia was considered, after unsuccessful attempts to establish the airway. As we failed to perform a subarachnoid block by the standard midline approach, due to anatomical/technical difficulties, we attempted the Taylor's approach [Figure 2], which is a modification of the paramedian approach for spinal anesthesia. It has all the advantages of the paramedian approach and also it is carried out at the L5-S1 interspace, the largest interlaminar space of the vertebral column. A spinal needle is inserted in a cephalomedial direction through a skin wheal raised 1 cm medial and 1 cm caudad to the lowermost prominence of the posterosuperior iliac spine.[1415] We succeeded by this approach in the first attempt.

Bottom Line: Fiberoptic bronchoscopy was attempted, but without success.This resulted in adequate sensory and motor blockade for the surgical procedure.The patient did not require airway interventions, but equipment and aids to secure airway were available.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Intensive Care and Pain Management, Himalayan Institute of Medical Sciences, Dehradun, Uttaranchal, India.

ABSTRACT
We describe a patient with long-standing ankylosing spondylitis who underwent percutaneous nephrolithotomy under spinal anesthesia. At preoperative assessment, it was considered that intubation of the trachea was likely to be difficult. Fiberoptic bronchoscopy was attempted, but without success. As the standard technique for spinal anesthesia failed, a variation of the paramedian approach in the lumbosacral approach, also known as Taylor's approach was successfully attempted. This resulted in adequate sensory and motor blockade for the surgical procedure. The patient did not require airway interventions, but equipment and aids to secure airway were available.

No MeSH data available.


Related in: MedlinePlus