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BJA Advance Access published online on February 4, 2005
British Journal of Anaesthesia, doi:10.1093/bja/aei076
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journal.permissions@oupjournals.org
Accepted November 24, 2004

Case Report

Dural ectasia: a likely cause of inadequate spinal anaesthesia in two parturients with Marfan's syndrome

H. J. Lacassie 1, S. Millar 2, L. G. Leithe 3, H. A. Muir 4, R. Montaña 5, A. Poblete 6, and A. S. Habib 4*

1 Department of Anaesthesiology, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago 833-0024, Chile; Department of Anaesthesiology, Duke University Medical Center, Durham, North Carolina 27710, USA
2 Department of Anaesthesia, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK
3 Department of Neuroradiology, Duke University Medical Center, Durham, North Carolina 27710, USA
4 Department of Anaesthesiology, Duke University Medical Center, Durham, North Carolina 27710, USA
5 Department of Anaesthesiology, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago 833-0024, Chile
6 Department of Obstetrics and Gynaecology, Pontificia Universidad Católica de Chile, Marcoleta 367, Santiago 833-0024, Chile

* To whom correspondence should be addressed.
A. S. Habib, E-mail: habib001{at}mc.duke.edu


  Abstract

We report two cases of Caesarean section in patients with Marfan's syndrome where continuous subarachnoid anaesthesia failed to provide an adequate surgical block. This was possibly because of dural ectasia, which was confirmed by a computed tomography scan in both cases.

Keywords: anaesthesia, obstetric; anaesthetic techniques, subarachnoid; complications, dural ectasia; complications, Marfan's syndrome; surgery, Caesarean section.
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