Continuous spinal anesthesia in a patient with ankylosing spondylitis for total hip replacement

Abstract

Ankylosing spondylitis (AS) is an autoimmune spondyloarthropathy, primarily affecting spine and sacroiliac joints. Other joints including hip, knee, ankle, shoulder, wrist, and temporomandibular joints may be involved. Patients with AS usually present for knee and hip joint replacement and corrective spinal surgery. They pose a challenge to the anesthetist because of difficult airway, restrictive lung disease, and difficulty in performing regional blocks due to fused spinal spaces. Both general and regional (spinal, epidural, combined spinal epidural) anesthesia have been used for the management of these patients. We share our experience of managing a 44 years old male patient with AS with difficult neuraxial approach, for total hip replacement using continuous spinal anesthesia.