Cauda equina syndrome following combined spinal and epidural anesthesia: a case report

Abstract

This case suggests that spinal anesthesia, even with an ordinary dose of hyperbaric 0.5% bupivacaine, might induce cauda equina syndrome in older patients.

Neurotoxicity Induced by Bupivacaine via T-Type Calcium Channels in SH-SY5Y Cells

“…One multicenter study found that the incidence of TNS was approximately 8.1%, which resulted in pain or sensory abnormalities in the lower back, buttocks, or lower extremities, with symptoms beginning after spinal anesthesia and lasting for hours to 4 days [5]. Although there is low incidence of anesthetic-induced cauda equina syndrome, it results in severe damage to neurons [6]–[8].…”

Therapeutic effects of intrathecal versus intravenous monosialoganglioside against bupivacaine-induced spinal neurotoxicity in rats

“…such as cauda equina syndrome [1,21], which raises concerns for its use. Although the pathogenesis for bupivacaine-induced neurotoxicity is unclear, several studies have shown that bupivacaine-induced neuronal damages may be attributed to neuron apoptosis.…”

“…However, many neurological spine disorders post spinal anesthesia have been caused by such local anesthetics, even at normal clinic dose, leading to neurological complications such as permanent nerve damage and cauda equina syndrome (CES) [1][2][3]. Although the incidence of local anesthetics-induced neurotoxicity is less than 0.04% [4,5], the resultant neural dysfunctions incur a low-quality life and an economic burden to the affected individuals.…”

Urinary retention occurring one week after spinal anesthesia: a case of Elsberg syndrome

“…8,9 In addition to urinary retention, the neurological symptoms can include fecal incontinence, perianal hypoesthesia, and possibly a negative MRI, as reported by Kato et al 8 As for MRI findings, however, in one case report of a patient with transient neurologic symptoms, enhancement of the mildly thickened cauda equina and lumbosacral nerve roots on a post contrast study was described as being attributed to lidocaine neurotoxicity. 10 MRI in viral myeloradiculitis may also show varying degrees of root or lower spinal cord edema with enlargement and hypersensitivity on T2-weight images in some patients, 4 though this was normal in our patient.…”