CASE REPORT
Year : 2023  |  Volume : 17  |  Issue : 1  |  Page : 110-112

The lumbar subcutaneous fat gradient in spinal anesthesia seen for morbidly obese patient with pre-procedure ultrasonography – A case report


Department of Anesthesiology, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan

Correspondence Address:
Hiroki Nakamura
Department of Anesthesiology, Tsuchiura Kyodo Hospital, 4-1-1 Otsuno, Tsuchiura, Ibaraki 300-0028
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sja.sja_562_22

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It has been reported that pre-procedure ultrasonography rises the success rate of spinal anesthesia in obese patients. In this article, we performed spinal anesthesia for morbidly obese patient with pre-procedure ultrasonography. And recognizing the lumbar subcutaneous fat gradient in morbidly obese patient was the key to success. A cesarean section was scheduled for a primigravida in her 30 s with BMI 61 kg/m2. The lumbar spine was not palpable. Pre-procedure ultrasonography revealed lumbar subcutaneous tissue getting thicker caudally in the sagittal view. Considering this fact, we adjusted the puncture site and succeeded. Postoperative complications were not observed. The pre-procedure ultrasonography is effective even in morbidly obese patients. It is important to recognize the lumbar subcutaneous fat gradient, the so-called back fat slope, for spinal anesthesia in obese patients.


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