Recent Case

[drccw]

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54 yo F for excision of a right posterior thigh neurofibroma (estimated size of said NF- 18 cm in length) by the orthopedic oncologists (my predicted EBL 750-1200cc)

PMH: NF I, significant scoliosis, chronic pain (total MS Contin dose over the day: 500 mg)

MRI of her spine confirmed the significant scoliosis

Labs showed no significant abnormalities (HCt 34, INR nml, plts nml)

any thoughts?

 

[urge]

pent, sux, tube?

 

[VentdependenT]

Tube.

Sciatic catheter if no pre-existing neruologic deficit.

 

[dhb]

Is the pain related to the neurofibroma or to other problems? If your not doing a regional a little K will do her good. Scoliosis doesn't really scare me for a lumbar epidural but i guess it's a little overkill for this procedure.

 

[fval28]

Is the pain related to the neurofibroma or to other problems? If your not doing a regional a little K will do her good. Scoliosis doesn't really scare me for a lumbar epidural but i guess it's a little overkill for this procedure.

NF1= no epidural or spinal.... agree with sciatic block and put her to sleep.

 

[dhb]

NF1= no epidural or spinal.... agree with sciatic block and put her to sleep.

http://www.anesthesia-analgesia.org/cgi/content/full/97/6/1855-a

 

[VentdependenT]

im not ordering an mri so i can do a spinal

 

[dhb]

I know
I just don't see the difference between putting a needle close to his sciatic nerve vs spinal roots (with a 27g quincke)

 

[VentdependenT]

I know
I just don't see the difference between putting a needle close to his sciatic nerve vs spinal roots (with a 27g quincke)

I see a big difference holmes.

 

[Jeff05]

if no MRI, then GETA. if MRI epidural for postop pain management and GETA.