{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T20:26:44Z","timestamp":1787776004324,"version":"build-2784847793"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>BSTRACT<\/jats:sc>\n                  <\/jats:title>\n                  <jats:p>Anesthetists pose different challenges in burn cases associated with polytrauma. Here, we present a case of a 35-year-old male electrician with an electric burn and a fall from height who sustained major chest trauma (hemothorax, pneumothorax, emphysema, and multiple rib fracture, and bilateral femur fracture). The collocated burn over the spinal region posed the challenge to administering a subarachnoid block, which was overcome with a paramedian approach anesthesia. The surgical outcome was good, and the patient was stable post-surgery. The paramedian approach provides an excellent alternative to the midline approach for spinal anesthesia. It should be considered in burn patients where it is impossible for the patient to flex, where the intervertebral space is very low, or when there is a burn present over the spinal region. Ultimately, early therapy and mobility goals, two essential components of burn care and rehabilitation, can be achieved with the use of paramedian regional anesthesia.<\/jats:p>","DOI":"10.4103\/jfmpc.jfmpc_1245_24","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T09:05:37Z","timestamp":1736759137000},"page":"502-505","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["\u201cSubarachnoid block in active burn injury\u201d: A case report of anesthetic challenges and considerations"],"prefix":"10.4103","volume":"14","author":[{"given":"Rutuja","family":"Gohad","sequence":"first","affiliation":[{"name":"Department of Anesthesia, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudha S.","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shubham","family":"Rahane","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dushyant","family":"Bawiskar","sequence":"additional","affiliation":[{"name":"Sports Medicine, Abhinav Bindra Sports Medicine and Research Institute, Bhubaneshwar, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,1,13]]},"reference":[{"key":"R2-20260109","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1177\/000313480206800305","article-title":"Burns with multiple 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Surg"},{"key":"R11-20260109","first-page":"113","article-title":"The relationship of D-dimer levels with risk for developing deep-vein thrombosis and\/or pulmonary thromboembolism after orthopaedic trauma surgery","volume":"21","author":"Naeem","year":"2009","journal-title":"J Ayub Med Coll Abbottabad"},{"key":"R13-20260109","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.1213\/01.ane.0000287655.95619.fa","article-title":"The paramedian technique: A superior initial approach to continuous spinal anesthesia in the elderly","volume":"105","author":"Rabinowitz","year":"2007","journal-title":"Anesth Analg"},{"key":"R14-20260109","first-page":"72","article-title":"A comparative evaluation between median and paramedian approaches for sub-arachnoid block in elderly patients","volume":"2069","author":"Singh","year":"2016","journal-title":"Int J Res Med Sci"},{"key":"R15-20260109","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/S0377-1237(02)80038-7","article-title":"Lateral approach: A better technique for spinal anaesthesia in the modern era","volume":"58","author":"Khanduri","year":"2002","journal-title":"Med J Armed Forces India"},{"key":"R16-20260109","doi-asserted-by":"crossref","first-page":"518","DOI":"10.4097\/kja.19409","article-title":"Incidence of newly developed postoperative low back pain with median versus paramedian approach for spinal anesthesia","volume":"73","author":"Lee","year":"2020","journal-title":"Korean J Anesthesiol"},{"key":"R17-20260109","doi-asserted-by":"crossref","first-page":"268","DOI":"10.4103\/aer.aer_130_21","article-title":"A randomized comparative study on median and paramedian approaches for subarachnoid block using sprotte needle in the cesarean section: Quest for the best","volume":"15","author":"Kumari","year":"2021","journal-title":"Anesth Essays Res"}],"container-title":["Journal of Family Medicine and Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_1245_24","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:46:52Z","timestamp":1787773612000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jfmpc.jfmpc_1245_24"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/jfmpc.jfmpc_1245_24","relation":{},"ISSN":["2249-4863","2278-7135"],"issn-type":[{"value":"2249-4863","type":"print"},{"value":"2278-7135","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-07-20","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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