Cesarean Section in a Heart Failure Patient with Previous Lumbosacral Spine Surgery

A 29-year-old female with a history of nonischemic cardiomyopathy and lumbosacral spine surgery presents for Cesarean section. A carefully titrated continuous lumbar epidural was used as the primary anesthetic with an intrathecal injection of fentanyl to augment the block. Ultrasound guidance was used to facilitate placement of the epidural catheter given the patient’s history of lumbosacral spine surgery.