ArticleCureus2026
High Spinal Block After Intrathecal Mepivacaine in Ankylosing Spondylitis During Total Hip Arthroplasty: A Case Report.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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3 authors.
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Abstract
Ankylosing spondylitis (AS) complicates anesthetic management due to altered spinal anatomy and potential airway difficulties. Neuraxial anesthesia is feasible but technically challenging, with potentially variable drug distribution. High spinal block reports in AS remain limited. This report describes the case of a 58-year-old male patient with AS who underwent elective total hip arthroplasty under spinal anesthesia (3.5 mL 2% isobaric mepivacaine). An initial T11 sensory block rapidly progressed cephalad to C6 within minutes, causing upper extremity weakness, bradycardia, and hypotension. Concern for impending total spinal anesthesia prompted conversion to general anesthesia for airway and hemodynamic control. The patient recovered fully without neurologic deficits. This case illustrates the potential for unpredictable intrathecal anesthetic spread in AS despite standard dosing. Careful monitoring, minimal sedation, and immediate readiness for advanced airway management are crucial during neuraxial anesthesia in patients with AS.
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