BMJ Case Reports 2012; doi:10.1136/bcr-2012-006294
  • Unusual presentation of more common disease/injury

Subarachnoid block in a case of rheumatoid arthritis with severe pulmonary fibrosis

  1. Zaid Ahmad2
  1. 1Department of Anatomy, JN Medical College, Aligarh, Uttar Pradesh, India
  2. 2Department of Anesthesiology and Critical Care, JN Medical College, Aligarh, Uttar Pradesh, India
  1. Correspondence to Dr Mohd Salahuddin Ansari, msalahuddin.ansari12{at}


Rheumatoid arthritis (RA) is the most common chronic inflammatory arthritis, of unknown aetiology and a propensity to involve almost all organ systems. The anaesthesiologists should be aware of the associated airway pathologies, pain management techniques and adverse effects of drug therapies being used to treat RA. In this respect, we describe a 60-year-old female patient who presented with a diagnosis of RA with pulmonary fibrosis, and was scheduled for orthopaedic surgery for subcapital fracture of femur which was successfully managed using intrathecal bupivacaine and midazolam.

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