A patient with postpolio syndrome developed cauda equina syndrome after neuraxial anesthesia: A case report.
J Clin Anesth
; 37: 49-51, 2017 Feb.
Article
in En
| MEDLINE
| ID: mdl-28235527
ABSTRACT
Combined spinal anesthesia and postoperative epidural analgesia is widely used in orthopedic surgery. Uncommon but serious neurologic complications of neuraxial anesthesia (NA) include direct trauma during needle or catheter insertion, central nervous system infections, and neurotoxicity of local anesthetics. Cauda equina syndrome (CES) is a rare complication after NA but can result in severe neurologic deterioration that may require surgical intervention. We present a case of a 69-year-old woman with postpolio syndrome who developed CES after combined spinal anesthesia and postoperative epidural analgesia. Perioperative observations and follow-up examinations, including magnetic resonance imaging, revealed no evidence of direct needle- or catheter-induced trauma, spinal hematoma, spinal ischemia, intraneural anesthetic injection, or infection. We speculate that CES symptoms were observed because of enhanced sensitivity to a combination of regional anesthetic technique-related microtrauma and neurotoxicity of bupivacaine and ropivacaine. Thus, practitioners should be aware that patients with preexisting neurologic diseases may be at increased risk for CES after NA.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Polyradiculopathy
/
Analgesia, Epidural
/
Analgesia, Patient-Controlled
/
Postpoliomyelitis Syndrome
/
Anesthesia, Spinal
/
Anesthetics, Local
Type of study:
Diagnostic_studies
Limits:
Aged
/
Female
/
Humans
Language:
En
Journal:
J Clin Anesth
Journal subject:
ANESTESIOLOGIA
Year:
2017
Document type:
Article