Thoracic Epidural Analgesia in a Patient With Achondroplasia on Buprenorphine: A Case Report

Achondroplasia, a common bone disorder, presents unique challenges for neuraxial anesthesia due to spinal anatomy variations. Thoracic epidural analgesia can provide effective perioperative pain control and enhance recovery, but evidence to guide its use in this population is limited. We describe the perioperative management of an achondroplastic patient with chronic pain on buprenorphine undergoing urgent major abdominal surgery. The case details technical considerations for thoracic epidural placement, multimodal analgesia, and postoperative care. This report supports the feasibility and safety of thoracic epidurals in achondroplastic patients and highlights their potential role in optimizing outcomes for this complex population.