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BMJ Case Rep ; 15(3)2022 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-35241447

RESUMO

Neuraxial anaesthesia is an essential technique in obstetric anaesthesia practice. Cerebrospinal fluid (CSF) fistula is a rare complication and there is no consensus about its clinical approach. We present a case of a 28-year-old nulliparous woman that developed a cutaneous CSF fistula following combined spinal and epidural block for caesarean delivery. After multidisciplinary discussion it was decided that hydration, absolute bed-rest and compressive dressing with abdominal binder was the best option and the patient fully recovered without any sequelae.Based on literature, symptoms of intracranial hypotension and leakage of clear fluid surrounding the puncture site usually motivate referral to anaesthesia. Management strategies can be both conservative and invasive, including direct suture of the skin puncture site and epidural blood patch.Regarding the anaesthesia practice on this topic, most of the available evidence is based on case reports, rendering the decision-making process challenging.


Assuntos
Anestesia Obstétrica , Fístula Cutânea , Hipotensão Intracraniana , Adulto , Placa de Sangue Epidural/efeitos adversos , Placa de Sangue Epidural/métodos , Vazamento de Líquido Cefalorraquidiano/complicações , Vazamento de Líquido Cefalorraquidiano/terapia , Fístula Cutânea/etiologia , Feminino , Humanos , Hipotensão Intracraniana/complicações , Hipotensão Intracraniana/terapia , Gravidez , Punção Espinal/efeitos adversos
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