{
  "abstract": "Background and Aims Lumbar tattoos have become increasingly common, especially among young adults. Although not considered an absolute contraindication for regional anesthesia, concerns persist regarding potential complications, including the introduction of pigment into the neuraxial space.Methods We report the case of a 34-year-old pregnant woman at 38 weeks with gestational diabetes, who required an emergency cesarean section. She had a large tattoo covering her entire lumbar region, leaving no unaffected skin for puncture. Spinal anesthesia was performed using a 27G needle under strict aseptic technique. The patient refused a skin incision prior to puncture.Results The procedure was completed without complications. However, literature highlights theoretical risks: organic tattoo pigments may be neurotoxic if introduced into the spinal canal, and ink particles may trigger localized immune responses leading to inflammation or neural damage. The phenomenon of ‘coring’—where a fragment of tattooed skin is carried into the spinal space by the needle—has been described. To minimize this risk, some experts recommend a small skin incision, which was not possible in this case due to patient refusal. The patient was informed of potential complications and advised to report any symptoms. She was also warned about possible risks during future MRI scans. At 6 months follow-up, the patient was contacted by telephone and reported no complications, confirming an uneventful recovery.Abstract OP21 Figure 1Full view of the patient´s lumbar tattoo areaAbstract OP21 Figure 2Needle insertion through the lumbar tattoo using a 27-gauge spinal under aseptic conditionsAbstract OP21 Figure 3Administration of local anaesthetic through the spinal needleConclusions While spinal anesthesia through tattooed skin is not absolutely contraindicated, it should be approached with caution. Informed consent, thorough risk assessment, aseptic technique, and proper documentation are essential when alternative puncture sites are unavailable. However, due to the limited data available, further research and continued clinical vigilance are recommended.",
  "authors": [
    {
      "affiliations": [
        "Departamento de Anestesiologia, Reanimacion Y Terapia Del Dolor, Centro De Asistencia Del Sindicato Medico Del Uruguay, Montevideo, Uruguay"
      ],
      "name": "Bonifacio Fabricio Machado Olano"
    },
    {
      "affiliations": [
        "Clinical Dermatology, British Hospital, Montevideo, Uruguay"
      ],
      "name": "Alejandra Larre Borges"
    },
    {
      "affiliations": [
        "Division of Pain Medicine, Departament of Anesthesiology, Reanimation and Pain Medicine, Hospital Clinic De Barcelona, University of Barcelona, Barcelona Spain, Barcelona, Spain"
      ],
      "name": "Rosario Armand Ugon"
    },
    {
      "affiliations": [
        "Departament of Oncology, Hospital De Clinicas, Universidad De La Republica, Montevideo, Uruguay"
      ],
      "name": "Cecilia Castillo"
    },
    {
      "affiliations": [
        "Departament of Anesthesiology, Critical Care and Pain Medicine, Consorci Sanitari Integral De Barcelona, Barcelona, Spain"
      ],
      "name": "Cesar Gracia Fabre"
    },
    {
      "affiliations": [
        "Candidate for the Histology Department. Medical Student, Faculty of Medicine University of the Republic, Montevideo, Uruguay"
      ],
      "name": "Jose Renato de Sousa Passos"
    }
  ],
  "title": "OP21 Spinal anesthesia in patients with lumbar tattoos: case report and literature review",
  "uid": "74bb74d6-6b04-5d08-8bf0-31b4f07ede2b"
}