Combined spinal and epidural anaesthesia for an elective Caesarean section in a patient with achondroplasia

  • Ambrose Rukewe University College Hospital
  • Imran Oludare Morhason-Bello University of Ibadan
  • Akinola Fatiregun University College Hospital
  • Mathias Orji University College Hospital
Keywords: achondroplasia, anaesthesia, regional blocks, combined spinal epidural anaesthesia


We describe the use of combined spinal and epidural anaesthesia in a 32-year-old parturient with achondroplasia who presented for an elective Caesarean section. A low-dose spinal block, using 5 mg 0.5% hyperbaric bupivacaine with 10 μg fentanyl, was inadequate (sensory loss up to T10). Sensory loss was extended by an epidural bolus of 5 ml 0.5 % isobaric bupivacaine to T6 within 15 minutes for surgery, which lasted 33 minutes. This titratable regional anaesthetic technique proved to be a viable option in the care of this patient.

Author Biographies

Ambrose Rukewe, University College Hospital
Consultant Anaesthetist Anaesthesia Department University College Hospital Ibadan Nigeria
Imran Oludare Morhason-Bello, University of Ibadan
Consultant: Obstetrician & Gynaecologist Department of Obstetrics & Gynaecology College of Medicine University of Ibadan University College Hospital
Akinola Fatiregun, University College Hospital
Consultant Epidemiologist Faculty of Public Health Department of Epidemiology Medical Statistics & Environmental Health College of Medicine University College Hospital
Mathias Orji, University College Hospital
Registrar Anaesthetist Department of Anaesthesia University College Hospital
Case Studies