Abstract

This case report highlights the novel application of repeat spinal anaesthesia as a viable alternative for achieving adequate surgical anaesthesia in a patient undergoing bilateral total knee arthroplasty after an initial failed epidural attempt. The patient, with a history of osteoarthritis, presented for elective surgery. An epidural attempt was unsuccessful due to technical difficulties, leading to spinal anaesthesia with 2.4 mL of 0.5% hyperbaric bupivacaine (12 mg) and 25 µg fentanyl. After 2 hours and 50 minutes, inadequate anaesthesia prompted a repeat spinal dose of 1.6 mL of 0.5% hyperbaric bupivacaine (8 mg). The procedure was completed without any complications, and the patient recovered well, leading to a successful discharge. This case highlights the efficacy and safety of repeat spinal anaesthesia as an alternative when epidural anaesthesia fails.

Key words: Total Knee Arthroplasty, Epidural Anaesthesia, Spinal Anaesthesia