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British Journal of Anaesthesia 2006 96(4):464-466; doi:10.1093/bja/ael036
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Segmental spinal anaesthesia for cholecystectomy in a patient with severe lung disease

A. A. J. van Zundert1,*, G. Stultiens2, J. J. Jakimowicz2, B. E. E. M. van den Borne3, W. G. J. M. van der Ham1 and J. A. W. Wildsmith4

1Department of Anesthesiology, ICU and Pain Therapy, Catharina Hospital—Brabant Medical School Michelangelolaan 2, NL-5623 EJ Eindhoven, The Netherlands
2Department of Surgery, Catharina Hospital—Brabant Medical School Michelangelolaan 2, NL-5623 EJ Eindhoven, The Netherlands
3Department of Pulmonology, Catharina Hospital—Brabant Medical School Michelangelolaan 2, NL-5623 EJ Eindhoven, The Netherlands
4Department of Anaesthesia, Ninewills Hospital & Medical School Dundee DD1 9SY, UK

*Corresponding author. E-mail: zundert{at}iae.nl

Occasionally patients awaiting heart or lung transplant because of terminal disease require other types of surgery, but present significant challenges to the anaesthetist because of impaired organ function. Regional anaesthesia may have much to offer such patients and we here report one who underwent successfully a laparoscopic cholecystectomy under segmental subarachnoid (spinal) anaesthesia performed at the low thoracic level. The anatomical and physiological consequences of such a technique are discussed.


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