Epidural Cyst With Cauda Equina Syndrome After Epidural Anesthesia

Wu, King‐Chuen; Chiang, Yi-Ying; Lin, Bih-Chern; Su, Hung-Tai; Poon, Kin-Shing; Shen, Mei-Ling; Wu, Rick Sai-Chuen

doi:10.1016/s1875-4597(10)60048-3

Cited by 6 publications

(9 citation statements)

References 22 publications

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“…CES after spinal anesthesia is very rare, with an incidence of 0.0027% [2,3], and is associated with varying degrees of symptoms, including bowel and bladder dysfunction, lower abdomen and back pain, insensate perineal areas and neurologic de cits in the lower limb [4]. Motor dysfunction, sensory dysfunction and abnormal evoked potentials are classi ed as neurologic de cits in the lower limb [5].…”

Section: Discussionmentioning

confidence: 99%

Tarlov cyst with self-healing cauda equina syndrome following combined spinal-epidural anesthesia: a case report

Chen

Lin

2023

Preprint

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Background Cauda Equina Syndrome (CES) after Combined Spinal-Epidural Anesthesia(CSEA) is a rare disease that most of the time need surgery to relieve spinal cord compression. Case Presentation A 34-year-old male patient underwent a procedure for prolapse and hemorrhoids (PPH) under CSEA. Anesthesia and surgery were uneventful. However, the patient gradually experienced urinary retention, lower abdomen and back pain, changes in bowel habits and neurological dysfunction of the lower limbs when the catheter was removed. It was later determined that the patient had Tarlov cyst at the left S1 level in the sacral canal. Finally, the patient completely recovered 20 days after drug conservative therapy onset. Conclusion This case suggests that CES might occur even after ordinary CSEA. The risk factors are drug neurotoxicity to ropivacaine and Tarlov cyst, which helped to accumulate ropivacaine. The development of ultrasound-guided CSEA and an ultrasound atlas of the spinal canal are required.

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Section: Discussionmentioning

confidence: 99%

Tarlov cyst with self-healing cauda equina syndrome following combined spinal-epidural anesthesia: a case report

Chen

Lin

2023

Preprint

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“…Few studies have implicated pre-existing lumbar pathology as playing an integral role in the development of CES following spinal or epidural anesthesia. [ 3 7 10 ] Kubina and colleagues reported CES following transurethral resection of a prostate using 3.6 mL bupivacaine with glucose (5 mg/mL) intrathecally. [ 3 ] The MRI scan performed postoperatively showed spinal stenosis at the L2-3 level.…”

Section: Discussionmentioning

confidence: 99%

“…Wu and colleagues described a female who received 3 mL of 2% lidocaine epidural anesthesia for uterine cervix conization resulting in CES. [ 10 ] The MRI demonstrated an epidural fluid accumulation around L5 and an incidental herniated intervertebral disc at L4-5. Despite an emergent surgical decompression, she continued to experience voiding abnormalities 5 years later.…”

Section: Discussionmentioning

confidence: 99%

Acute cauda equina syndrome following orthopedic procedures as a result of epidural anesthesia

Lbe

Iyer²,

et al. 2018

Surg Neurol Int

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Background:Cauda equina syndrome (CES) is a rare complication of spinal or epidural anesthesia. It is attributed to direct mechanical injury to the spinal roots of the cauda equina that may result in saddle anesthesia and paraplegia with bowel and bladder dysfunction.Case Description:The first patient underwent a hip replacement and received 5 mL of 1% lidocaine epidural anesthesia. Postoperatively, when the patient developed an acute CES, the lumbar magnetic resonance imaging (MRI) scan demonstrated clumping/posterior displacement of nerve roots of the cauda equina consistent with adhesive arachnoiditis attributed to the patient's previous L4-L5 lumbar decompression/fusion. The second patient underwent spinal anesthesia (injection of 10 mg of isobaric bupivacaine for an epidural block) for a total knee replacement. When the patient developed an acute CES following surgery, the lumbar MRI scan showed an abnormal T2 signal in the conus and lower thoracic spinal cord over 4.3 cm.Conclusions:Acute CES should be considered in patients undergoing spinal or epidural anesthesia for joint replacement surgery. Prompt evaluation with MRI studies may lead to appropriate medical/surgical measures to reverse the deficit.

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Section: Bradikardi Ve Kardiyak Arrestunclassified

“…Eğer yüksek dozda anestezik kazara yer değiştirmiş bir kateterden verilmişse, kateterden tekrarlayan bir şekilde küçük volümlerde beyin omurilik sıvısı boşaltılması ve yerine serum fizyolojik enjekte edilmesi önerilmektedir. 21,22 Enfektif Komplikasyonlar Nöroaksiyal anestezi sonrası santral sinir sistemi enfeksiyonları nadir görülür ve literatürde sıklığı 1.1:100.000-2.6:100.000 oranında belirtilmektedir. 24 Bakteriyel menenjit epidural anestezi sonrası da görülebilmektedir.…”

Section: Bradikardi Ve Kardiyak Arrestunclassified

Serious complications of epidural anesthesia

Doğru¹

2012

Dicle Med J

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ABSRACTEpidural anesthesia is a well-recognized and identified regional anaesthesia technique in anesthesia practice. First applied at sacral region in 1895 by Cathelin and today it has become a basic regional anaesthesia technique. Frequent application of epidural anesthesia has caused an increase at serious complications like bradycardia, cardiac arrest, neurologic and infective complications. But now, it has become a frequent practice for anesthesiologists under developments in practices and techniques.We aim to review serious complications of epidural anesthesia within current literatures.

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Epidural Cyst With Cauda Equina Syndrome After Epidural Anesthesia

Cited by 6 publications

References 22 publications

Tarlov cyst with self-healing cauda equina syndrome following combined spinal-epidural anesthesia: a case report

Tarlov cyst with self-healing cauda equina syndrome following combined spinal-epidural anesthesia: a case report

Acute cauda equina syndrome following orthopedic procedures as a result of epidural anesthesia

Serious complications of epidural anesthesia

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