Ultrasound-Guided Neuraxial Anaesthesia for Vaginal Hysterectomy in a Patient With Rheumatoid Arthritis

Rheumatoid arthritis is a type of chronic inflammatory arthritis affecting about 1% of the population. Females are more frequently affected than males. The aetiology of the disease is uncertain. Immunological, genetic and environmental factors play a role in the manifestations. The condition is characterised by a combination of articular symptoms and multi-organ involvement. These pose a wide array of difficulties in administering anaesthesia for patients with rheumatoid arthritis. These patients are prone to have a problem in airway management due to arthritic changes in the cervical spine and temporomandibular joint and in the administration of neuraxial anaesthesia owing to changes occurring in the vertebral column. We present a case of a 45-year-old female with rheumatoid arthritis posted for a vaginal hysterectomy. The patient had narrowed intervertebral spaces and was managed successfully by the use of ultrasonography to place an epidural catheter and for the administration of subarachnoid block for the conduct of the procedure.