Intravenous mannitol for treatment of abducens nerve paralysis after spinal anesthesia

Aminisaman, Javad; Karbasfrushan, Ali; Ahmadi, Abbas; Bazargan-Hejazi, S.

doi:10.1016/j.ijoa.2011.02.001

Cited by 6 publications

(4 citation statements)

References 15 publications

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“…24,27,30 Epidural blood patch is most effective for treating PDPH (93% effectiveness), but it has not been demonstrated to be an efficacious treatment for EOMP. 8,25,27,28,30,33,36,50 In the 114 cases in our review, 2 patients underwent prophylactic EBP during the first 24 to 48 hours. Nevertheless, it did not restore the function of cranial nerves, not even when headaches were fully resolved, and both cases required surgery.…”

Section: Resultsmentioning

confidence: 99%

Ocular Motor Palsy After Spinal Puncture

del-Río-Vellosillo

García-Medina

Pinazo-Durán

et al. 2017

Regional Anesthesia and Pain Medicine

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Ocular motor palsy is a rare but alarming complication of subarachnoid puncture. In order to better understand this condition, a literature search was performed in English of PubMed articles for cranial nerves III, IV, and VI palsies after spinal puncture. Sixty-five articles (dated 1930-2015) were identified, and 114 cases were obtained for analysis. Subarachnoid anesthesia was the most frequent cause (45.6%), with a higher incidence for females than males. The age of patients was 40.24 ± 13.35 years (age range, 6-71 years). The sixth cranial nerve was the most commonly involved (92.1%), with higher frequency in the right eye. Palsy onset started 7.30 ± 4.09 days after puncture. Duration in reversible cases was 80.10 ± 80.67 days. Paresia was permanent in 13 patients, but only 2 patients required extraocular muscle surgery. Treatments included the horizontal position along with analgesics, fluid therapy, and corticosteroids. The usefulness of blood patch remains controversial. It is important for anesthesiologists and other physicians to recognize the cardinal features of this process to ensure early diagnosis, avoid unnecessary tests, and guide appropriate treatment.

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Section: Resultsmentioning

confidence: 99%

Ocular Motor Palsy After Spinal Puncture

del-Río-Vellosillo

García-Medina

Pinazo-Durán

et al. 2017

Regional Anesthesia and Pain Medicine

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“…In the follow-up, the symptoms were improved in the patients after revision surgery. The other ten patients with PRSPSM < 5′ were treated by conservative methods (absolute bed rest, methylprednisolone 80 mg intravenous injection twice a day, 20% mannitol 125 ml intravenous drip twice a day and mecobalamin 500 mg orally three times a day) 13 - 16 for seven days, and were discharged when PRSPSM was lower than 5′ at the second assessment. At three-month follow-up, most patients, except case seven, were in gradual rehabilitation with normal motion post-operatively.…”

Section: Resultsmentioning

confidence: 99%

Treatment strategies for early neurological deficits related to malpositioned pedicle screws in the lumbosacral canal

et al. 2016

Bone & Joint Research

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ObjectivesTo employ a simple and fast method to evaluate those patients with neurological deficits and misplaced screws in relatively safe lumbosacral spine, and to determine if it is necessary to undertake revision surgery.MethodsA total of 316 patients were treated by fixation of lumbar and lumbosacral transpedicle screws at our institution from January 2011 to December 2012. We designed the criteria for post-operative revision scores of pedicle screw malpositioning (PRSPSM) in the lumbosacral canal. We recommend the revision of the misplaced pedicle screw in patients with PRSPSM = 5′ as early as possible. However, patients with PRSPSM < 5′ need to follow the next consecutive assessment procedures. A total of 15 patients were included according to at least three-stage follow-up.ResultsFive patients with neurological complications (PRSPSM = 5′) underwent revision surgery at an early stage. The other ten patients with PRSPSM < 5′ were treated by conservative methods for seven days. At three-month follow-up, only one patient showed delayed onset of neurological complications (PRSPSM 7′) while refusing revision. Seven months later, PRSPSM decreased to 3′ with complete rehabilitation.ConclusionsThis study highlights the significance of consecutively dynamic assessments of PRSPSMs, which are unlike previous implementations based on purely anatomical assessment or early onset of neurological deficits.and also confirms our hypothesis that patients with early neurological complications may not need revision procedures in the relatively broad margin of the lumbosacral canal.Cite this article: X-J. Lin. Treatment strategies for early neurological deficits related to malpositioned pedicle screws in the lumbosacral canal: A pilot study. Bone Joint Res 2016;5:46–51. DOI: 10.1302/2046-3758.52.2000477.

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“… 28 With this mechanism, mannitol infusion also was successfully used by Amini-Saman et al to treat a parturient with abducens nerve palsy after cesarean section under spinal anesthesia. 29 …”

Section: Discussionmentioning

confidence: 99%

The comparison of post-dural puncture headache treatment with acetaminophen-caffeine capsule and intravenous mannitol infusion: A randomized single-blind clinical trial

Shahriari¹,

Nataj-Majd²,

Khooshideh³

et al. 2021

CJN

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Background: Post-dural puncture headache (PDPH) is a common problem after spinal anesthesia. Depending on the severity of PDPH, there are both invasive and non-invasive treatments. Caffeine has been used for the treatment of PDPH since 1949, but the administration of mannitol is a novel management to tackle PDPH. This study was conducted to compare the effectiveness of acetaminophen-caffeine and mannitol in the treatment of PDPH. Methods: We enrolled 80 patients with PDPH in the present clinical trial and observed them during 72 hours after cesarean section. Participants were randomly and equally allocated to two groups for treatment with intravenous (IV) mannitol or oral acetaminophen caffeine. The effects of treatment were evaluated using the visual analogue scale (VAS) questionnaire at hours of 1, 2, 3, 4, 6, 12, 18, 24, and 48. SPSS software was used. Results: Forty patients in each group completed the study. There was a significant reduction in the pain scores of the both groups after treatment, but the interaction between time and group demonstrated that mannitol administration was superior to acetaminophen-caffeine in pain reduction of the patients undergoing spinal anesthesia (P = 0.028). Patients’ satisfaction in the mannitol group was significantly higher than the caffeine group (P = 0.001). Conclusion: This study suggests that IV mannitol infusion affects faster and earlier for the treatment of PDPH than acetaminophen-caffeine capsule. Mannitol could be probably more effective for treatment of PDPH.

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Intravenous mannitol for treatment of abducens nerve paralysis after spinal anesthesia

Cited by 6 publications

References 15 publications

Ocular Motor Palsy After Spinal Puncture

Ocular Motor Palsy After Spinal Puncture

Treatment strategies for early neurological deficits related to malpositioned pedicle screws in the lumbosacral canal

The comparison of post-dural puncture headache treatment with acetaminophen-caffeine capsule and intravenous mannitol infusion: A randomized single-blind clinical trial

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