[Spinal anesthesia for a patient with epidermolysis bullosa hereditaria dystrophica]

A 39-year-old male with epidermolysis bullosa hereditaria dystrophica was scheduled for surgical excision of squamous cell carcinoma in the lower leg. Spinal anesthesia was chosen, because the skin of the puncture site for spinal anesthesia appeared to be dry and scarred, and to have less chance of infection. To avoid shear stress to the skin, we carefully performed anesthetic management including attachment of equipments associated with anesthesia, monitoring and surgery. However, we experienced some troubles and complications associated with anesthetic technique, such as pain on removing a dressing sheet, burning sensations induced by alcoholic stimuli for cold sign test and tent-like traction of the punctured skin on withdrawing the spinal needle.