Perioperative management of a spinocerebellar ataxia patient by epidural anesthesia is reported. A 67-year-old woman with left femur neck fracture underwent femoral head replacement. An epidural catheter was placed without difficulty at the L3-4 interspace using the loss of resistance technique. A total of 1% mepivacaine 13 ml was administered in divided doses to obtain bilateral T5 analgesic level. Hypotension (79 mmHg systolic) was observed transiently, and ephedrine 8 mg was administered which successfully elevated blood pressure. Overall, hemodynamics and respiratory status were stable. Postoperative analgesia was maintained by infusion of 0.2% ropivacaine at 2 ml x hr(-1). The patient's postoperative course was uneventful, and her neurologic conditions remained unchanged.
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