Chlorhexidine arachnoiditis

Kaufman, Léon

doi:10.1111/anae.12248

Cited by 3 publications

(1 citation statement)

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“…Adhesive arachnoiditis is an infrequent but severe complication of neuraxial blockade that potentially induces syringomyelia in severe cases [ 7 ]. Arachnoiditis is presumed to be triggered by conditions such as intrathecal infection and bleeding, local anesthetics, or contamination with chemicals such as chlorhexidine used for disinfection before neuraxial anesthesia [ 8 ]. Therefore, one of the potential explanations for this case is that the hyperbaric bupivacaine or the tiny amount of hemorrhage upon puncture could have accumulated around the left L5/S neuronal root and caused inflammation as she spent most of the time in the left lateral position after cesarean delivery.…”

Section: Discussionmentioning

confidence: 99%

Unilateral radiculopathy away from the puncture site due to adhesive arachnoiditis after spinal anesthesia for an emergent cesarean delivery: a case report

Shimizu

2022

JA Clin Rep

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Background Adhesive arachnoiditis has been described as a deteriorating neurological complication after neuraxial blockade; however, few pieces of literatures have reported minor cases that resemble peripheral neuropathy. Case presentation A 29-year-old nulliparous woman underwent an emergent cesarean delivery under spinal anesthesia at the second and third lumbar interspace (L2/3) without any specific concerns. Subsequently, she developed left L5 and sacral first (S1) radiculopathy that persisted for 2 months. Although the neurological findings more likely indicated peripheral neuropathy, magnetic resonance imaging revealed localized adhesive arachnoiditis at the left L5/S1 level. Her symptoms gradually improved and entirely disappeared within 2 months without any particular treatment. Conclusion The neurological symptoms that show a clear tendency to improve spontaneously do not always undergo a detailed workup. Therefore, such minor adhesive arachnoiditis might have occurred more than expected. Imaging such cases might cumulatively further the understanding of its etiology.

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Section: Discussionmentioning

confidence: 99%