ASRA Pain Medicine Update

Problem-Based Learning Discussion (PBLD): Perioperative Management of Spine Surgery

Jun 5, 2024, 12:46 PM by ASRA Pain Medicine

Case

Kaley is a 28-year-old 105kg female with a history of scoliosis and opioid-use disorder, currently on sublingual buprenorphine 8 mg three times a day, which was prescribed in the community. In addition, she admits to using other recreational drugs such as cannabis, around one joint a day. She uses a CPAP machine for obstructive sleep apnea, although there is a question regarding compliance. She also has bipolar disorder with anxiety, chronic migraine, fibromyalgia, as well as fatty liver disease. Her current medications are lithium, amitriptyline, and sumatriptan, together with her pain medication. She is scheduled for instrumentation and fusion from T2 to L2 of her spine in the prone position under general anesthetic.

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