Epidural abscess after epidural anesthesia and continuous epidural analgesia in a patient with gastric lymphoma

Hernandez, Josephine M; Coyle, Francis P; Wright, Cameron D.; Ballantyne, Jane C.

doi:10.1016/s0952-8180(02)00481-6

Cited by 7 publications

(8 citation statements)

References 14 publications

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“…Table 2 summarizes incidence results from representative studies of this complication. Although signs and symptoms such as severe back pain, local back tenderness, and fever have been associated in some series with epidural abscess,50 other case reports and series emphasize the potential for both atypical and delayed presentations of this problem, suggesting that a high index of suspicion has to be maintained when assessing signs and symptoms occurring after the use of neuraxial anesthesia or analgesia 51,52…”

Section: Infection Causing Neurological Adverse Eventsmentioning

confidence: 99%

Neurological adverse events following regional anesthesia administration

Kent

2010

LRA

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Regional anesthesia and analgesia have been associated with improved analgesia, decreased postoperative nausea and vomiting, and increased patient satisfaction for many types of surgical procedures. In obstetric anesthesia care, it has also been associated with improved maternal mortality and major morbidity. The majority of neurological adverse events following regional anesthesia administration result in temporary sensory symptoms; long-term or permanent disabling motor and sensory problems are very rare. Infection and hemorrhagic complications, particularly with neuraxial blocks, can cause neurological adverse events. More commonly, however, there are no associated secondary factors and some combination of needle trauma, intraneural injection, and/or local anesthetic toxicity may be associated, but their individual contributions to any event are difficult to define.

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Section: Infection Causing Neurological Adverse Eventsmentioning

confidence: 99%

Neurological adverse events following regional anesthesia administration

Kent

2010

LRA

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“…Epidural abscess is a rarer event than epidural hematoma, but it may be equally catastrophic and may cause permanent and serious neurological injury, even death [84]. The mortality of spinal abscess may be as high as 18% [85].…”

Section: [42 B ]mentioning

confidence: 99%

Does the evidence support the use of spinal and epidural anesthesia for surgery?

Ballantyne

Kupelnick

McPeek

et al. 2005

Journal of Clinical Anesthesia

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“…with an elevated white cell count or inflammatory markers [1][2][3]10,11 . This delay in diagnosis is associated with a greater likelihood of permanent neurological sequelae as well as increased mortality 2 .…”

Section: B 2amentioning

confidence: 99%

“…This delay in diagnosis is associated with a greater likelihood of permanent neurological sequelae as well as increased mortality 2 . Furthermore, although epidural abscesses usually present five days post catheter insertion, delayed presentation up to 32 days later has been reported 10,[12][13][14][15] . This raises the question whether it is direct spread of bacteria from the skin at time of insertion, or late haematogenous spread from a transient bacteraemia that actually results in formation of the abscess.…”

Section: B 2amentioning

confidence: 99%

“…Increased suspicion is also necessary in particular groups of patients, such as those with diabetes mellitus, concomitant infection, intravenous drug use, immuno-compromise or chronic medical illness, all being associated with an increased risk of developing epidural abscesses 10 . Diabetes has been identified as the most important risk factor 16 , with one study demonstrating that 13% of patients who presented with epidural abscesses without prior spinal injections had diabetes mellitus 17 .…”

Section: B 2amentioning

confidence: 99%

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Extensive Spinal Epidural Abscess Associated with an Unremarkable Recovery

Ansari

Davies

Lohn

et al. 2004

Anaesth Intensive Care

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Spinal epidural abscess is a rare complication of epidural catheter insertion, with an incidence reported to be as low as 0.02%, but with a high morbidity and mortality. This reflects the difficulty in diagnosis of the condition, as early symptoms and signs are usually non-specific with late neurological manifestations. We report a case of spinal epidural abscess in a diabetic patient who underwent splenectomy and distal pancreatectomy. Early investigation with magnetic resonance imaging was effective in demonstrating an extensive epidural abscess involving the thoracic spine, with extension to the base of the skull and associated cord compression. Extensive multilevel laminectomies with thorough irrigation and washout of the epidural space were successful in treating this patient and preventing the development of permanent neurological sequelae.

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Epidural abscess after epidural anesthesia and continuous epidural analgesia in a patient with gastric lymphoma

Cited by 7 publications

References 14 publications

Neurological adverse events following regional anesthesia administration

Neurological adverse events following regional anesthesia administration

Does the evidence support the use of spinal and epidural anesthesia for surgery?

Extensive Spinal Epidural Abscess Associated with an Unremarkable Recovery

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