Raquia complicada/Complicated spinal anesthesia

Meningitis iatrogénica despues de anestesia raquídea


IATROGENIC MENINGITIS AFTER SPINAL ANESTHESIA
R. Hashemi and A. Okazi
UNESCO Chair of Human Rights, Peace and Democracy, Bioethics Group, Shahid Beheshiti University, Tehran, Iran. Medicolegal Organization of Mazandaran, Sari, Iran
Acta Medica Iranica 2008; 46(5): 434-436.
Abstract.
Bacterial meningitis after spinal and epidural anesthesia is a very rare but serious complication. We report a case of meningitis developing a number of hours after a spinal block for Caesarean section. No organism was grown but the CSF pattern was suggestive of bacterial meningitis. Severe neurological sequelae were present after three months of hospitalization. Meningitis is a serious complication and its early diagnosis and effective treatment is essential. Meningitis should always be considered as a possible differential diagnosis in patients suspected of having post spinal headache, convulsion and changes in mental statues. A thorough knowledge and practice of aseptic techniques is crucial in performing spinal and epidural anesthesia.
Key words: Bacterial meningitis, spinal anesthesia, epidural anesthesia
http://journals.tums.ac.ir/upload_files/pdf/_/12267.pdf


Meningitis despues de raquianestesia

Meningitis after spinal anaesthesia.
SEBRECHTS J.
Br Med J. 1947 Aug 9;2(4518):226.
SIR,-Dr. C. A. Vuylsteke (B.M.J., Feb. 1, p. 179) reported four cases of pseudomonas meningitis following spinal anaesthesia. Three of these, caused by the melanogenes variety of Ps. pyocyanea, were fatal; one, caused by true Ps. pyocyanea, recovered after sulphathiazole treatment. Patients had been operated upon by three different surgeons at two surgical clinics whose nursing personnel belonged to the same school.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2055521/pdf/brmedj03741-0032f.pdf



Hematoma subaracnoideo despues de raquianestesia


Spinal subarachnoid hematoma after spinal anesthesia.
Jeon SB, Ham TI, Kang MS, Shim HY, Park SL.
Department of Anesthesiology and Pain Medicine, National Police Hospital, Seoul, Korea.
Korean J Anesthesiol. 2013 Apr;64(4):388-9. doi: 10.4097/kjae.2013.64.4.388.

Moen et al. reported that spinal hematoma occurred in 8 out of 1,260,000 cases of spinal anesthesia in Sweden, and subarachnoid hematoma is known to be very rare. We report a case of subarachnoid hematoma after spinal anesthesia in a patient without coagulopathy.
http://ekja.org/Synapse/Data/PDFData/0011KJAE/kjae-64-388.pdf



Tratamiento conservador de un hematoma despues de anestesia espinal: informe de caso y revisión de la literatura

Conservative treatment of hematoma after spinal anesthesia: case report and literature review.
Segabinazzi D, Brescianini BC, Schneider FG, Mendes FF.
FFCMPA.
Rev Bras Anestesiol. 2007 Apr;57(2):188-94.
Abstract
BACKGROUND AND OBJECTIVES: Spinal anesthesia caries the risk of bleeding. Compression of nervous tissue secondary to the formation of a hematoma can cause neurological damage, which, if not diagnosed and treated in a timely fashion, can be permanent. The identification of risk factors, diagnosis, and early treatment are important for the prognosis. The objective of this report was to describe the case of a hematoma after spinal anesthesia treated conservatively, and review the literature. CASE REPORT: Male patient, 73 years old, 65 kg, 1.67 m, and ASA physical status III, underwent spinal anesthesia for removal of a peritoneal dialysis catheter. During the puncture, the patient experienced paresthesia of the right lower limb. Fifteen milligrams of 0.5% hyperbaric bupivacaine without vasoconstrictor were administered. Twenty-four hours later, saddle anesthesia and lumbar pain persisted and, after 48 hours, the patient presented urinary incontinence. An MRI demonstrated the presence of an expansive subarachnoid process compressing the nerve roots (L4 and S1). After evaluation by the neurosurgeon, conservative treatment was instituted. The patient was discharged from the hospital on the 18th postoperative day, asymptomatic. CONCLUSIONS: The case reported here presented a good evolution with the conservative treatment.
http://www.scielo.br/pdf/rba/v57n2/en_08.pdf




Atentamente
Anestesiología y Medicina del Dolor
www.anestesia-dolor.org