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- W2071207546 abstract "In their recent letter on spinal anaesthesia in Paget's disease of bone, Murphy et al. (Murphy. Anaesthesia 1999; 54: 1227) have reminded us of the difficulties in spinal anaesthesia and deserve commendation for successfully managing regional anaesthesia in Paget's disease of bone. The following data, in my opinion, need to be mentioned to highlight the problems and to clarify further the situation they encountered. 1 Spinal needle type, gauge and position of patients. Smaller gauge needles are less manoeuvrable and may not bypass ossifications. Positioning in Paget's disease has to be done carefully as fractures may occur [2]. 2 Mention the levels at which repeated attempts were done and the levels at which the paramedian approach was done to highlight the adequacy of the interlaminar space and ligamentum flavum at those levels. 3 As ossification of ligaments, if present, is likely to be at a shorter distance from skin than dura, the depth of penetration from skin during both midline and paramedian approaches may be measured. The feel of ossified ligaments is usually different from bone. 4 Mention of postoperative complications such as postdural puncture headache, neurological deficits, etc. 5 Pre-operative radiological assessment of the entire spine may reveal a characteristic, ‘picture frame’ appearance, or even collapse of vertebral bodies. This aids in deciding the suitability of regional anaesthesia and the precautions to be taken. The cause of difficulty in these patients may indeed have been a compressed vertebra and narrow intervertebral distances [2]." @default.
- W2071207546 created "2016-06-24" @default.
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- W2071207546 date "2000-07-01" @default.
- W2071207546 modified "2023-09-26" @default.
- W2071207546 title "Spinal anaesthesia in Paget's disease of bone" @default.
- W2071207546 doi "https://doi.org/10.1046/j.1365-2044.2000.01557-7.x" @default.
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