Frequent Spinal Anesthesia in a Patient with Traumatic Lower Extremity Injury: A Case Report

Spinal anesthesia is a commonly used anesthetic technique for lower extremity surgery. Despite its widespread use, the acceptable frequency of repeated spinal anesthesia for a patient is unclear. Therefore, herein, we report a patient who frequently received spinal anesthesia.

A 21-year-old man with severe head and leg injury was admitted to the hospital after a motorcycle accident. On admission, he had a tracheal tube and GCS score of six. After emergency vascular and orthopedic surgeries under general anesthesia, he was transported to the ICU. Within 12 days of admission to the ICU, he was extubated with full awareness. After consultation with a neurosurgeon for spinal anesthesia, the patient received seven spinal anesthesia procedures for his lower extremity injury in a period of 15 days. Spinal anesthesia was performed at the L3 - L4 or L4 - L5 interspace with 24 or 25-gauge Quincke needles in the sitting position (12 - 15 mg of 0.5% hyperbaric bupivacaine) by four anesthesiologists. Despite performing several spinal anesthesia procedures, no neurologic sequelae were observed. Finally, he was discharged in a good overall condition. At a four-month follow-up, the patient was in a stable situation without any neurological complications.

This report emphasizes that spinal anesthesia with hypertonic bupivacaine could be used several times for a patient in some situation.