Related Experiment Video
Updated: Sep 29, 2025

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
Published on: January 31, 2025
Spinal anesthesia for cesarean section in a woman with an intrathecal baclofen pump
Heath Allen1, Ryu Komatsu2, Hani El-Omrani3
1Denali Anesthesia, Alaska Regional Hospital, 2801 Debarr Road, Anchorage, AK, 99508, USA.
Background:
Intrathecal baclofen pumps are commonly used for the management of lower extremity spasticity in the setting of spinal cord injury. There have been no reports of the performance of spinal anesthesia in patients with a pre-existing intrathecal baclofen pump.
Case Presentation:
A 29-year-old parturient presented for cesarean section. She had a history of spinal cord injury due to fractures of the thoracic vertebrae with lower extremity spasticity, which had been treated with an intrathecal baclofen pump inserted through lumbar (L) 3-L4 intervertebral space. Preoperative lumbosacral ultrasound was performed to identify the L4-5 interspace, and spinal anesthesia was performed through that space with a 25-gauge 3.5-inch-long Whitacre spinal needle. Thoracic (T) 4 dermatomal level anesthesia was achieved, and the patient underwent the cesarean section without requiring additional intravenous analgesic adjuncts.
Conclusions:
Spinal anesthesia can be successfully performed in patients with intrathecal baclofen pumps. Existing intrathecal catheters can be located with preoperative imaging, and ultrasound can be used to determine the vertebral levels below the intrathecal catheter through which spinal anesthesia can be performed safely.
Related Concept Videos
Local Anesthetics: Clinical Application as Spinal Anesthesia
Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Drug Delivery: Parenteral Route
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
One of the advantages of...
Parenteral Anesthetics: Overview
Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

