Inadequate Epidural Analgesia in a Parturient with Scoliosis Treated using the 60° Head-up Position and Additional Administration of Epidural Saline with a Local Anesthetic: A Case Report

Scoliosis is defined as lateral curvature of the spine. This condition is found in 2% of the population worldwide with a two-fold higher prevalence in women than in men [1]. The challenges faced by anesthesiologists in providing neuraxial analgesia for parturients with scoliosis are inability to identify the epidural space, multiple attempts before catheter insertion, long insertion time, patchy or inadequate analgesia, high likelihood of dural puncture, and low potential for the successful treatment of post-dural puncture headache. Here, we present a parturient with scoliosis, which had an unsatisfactory block with epidural analgesia that was successfully managed using the 60° head-up position and additional administration of epidural saline with a local anesthetic.