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Updated: Oct 16, 2025

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
Published on: January 31, 2025
Sequential Combined Spinal-epidural Anesthesia in a Multiple Comorbidity Patient: An Indispensable Tool in
Vishwadeep Singh1, Ashita Mowar1, Akhilesh Pahade1
1Department of Anesthesiology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India.
Abstract:
Primary total knee joint arthroplasty (TKA) is a frequently performed procedure as part of osteoarthritis treatment. Optimal perioperative analgesia will augment functional recovery, improve knee mobility, and reduce postoperative morbidity. Octa- and nonagenarians undergoing TKA are often considered particularly difficult to manage and involve high levels of competence due to associated comorbidities these patients present with. We report a case of a geriatric patient with coronary artery disease and low ejection fraction with pulmonary fibrosis who underwent successful total knee arthroplasty under sequential combined spinal-epidural anesthesia.
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