Research & Innovation in Anesthesia

Register      Login

VOLUME 6 , ISSUE 2 ( July-December, 2021 ) > List of Articles


Combined Spinal Epidural Overcoming a Lumbar Lipoma for Lower Limb Both Bone Fracture

Robin S Chacko, Krishna Prasad Thangarasu, Hariesh Annamalai

Keywords : Anesthesia, Epidural, Lipoma, Spinal

Citation Information : Chacko RS, Thangarasu KP, Annamalai H. Combined Spinal Epidural Overcoming a Lumbar Lipoma for Lower Limb Both Bone Fracture. Res Inno Anesth 2021; 6 (2):44-45.

DOI: 10.5005/jp-journals-10049-0103

License: CC BY-NC 4.0

Published Online: 26-11-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Lipomas are a commonly occurring tumor and this particular one brought about challenges to our plan of anesthesia owing to its location. General anesthesia was unwarranted owing to the nature of the surgery as well as the COPD that the patient was suffering from. With meticulous technique and good knowledge of anatomy, we safely executed combined spinal-epidural anesthesia for our patient, the highlight being threading the epidural catheter downward above the lipoma to position it optimally and administering the subarachnoid block from below the lipoma, which resulted in satisfactory intra- and postoperative outcomes.

  1. Fogel GR, Cunningham III PY, Esses SI. Spinal epidural lipomatosis: case reports, literature review and meta-analysis. Spine J 2005;5(2):202–211. DOI: 10.1016/j.spinee.2004.05.252.
  2. Thompson MD, Vasdev GM, Findlay JY. Epidural blockade for labor and cesarean section with associated L4-5 lipomyelocele. Anesthesiology 1999;90(4):1217–1218. DOI: 10.1097/00000542-199904000-00042.
  3. Saied NN, Helwani M. Successful lumbar epidural catheter placement through a lower back lipoma. Saudi J Anaesthesia 2013;7(1):83. DOI: 10.4103/1658-354X.109826.
  4. Rodgers A, Walker N, Schug S, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ 2000;321(7275):1493. DOI: 10.1136/bmj.321.7275.1493.
  5. Hamdani GA, Chohan U, Zubair NA. Clinical usefulness of sequential combined spinal epidural anaesthesia in high risk geriatric patients for major orthopaedic surgery. J Anaesth Clin Pharmacol 2002;18(2):163–166.
  6. Jeong IH, Lee JK, Moon KS, et al. Iatrogenic intraspinal epidermoid tumor: case report. Pediatr Neurosurg 2006;42(6):395. DOI: 10.1159/000095573.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.