Permanent Loss of Cervical Spinal Cord Function Associated with the Posterior Approach

Voermans, Nicol C.; Crul, B.J.P.; Bondt, Bert J. de; Zwarts, Machiel J.; Engelen, B.G.M. van

doi:10.1213/01.ane.0000190722.55703.61

Cited by 39 publications

(18 citation statements)

References 4 publications

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“…The posterior approach may provide some advantages over lateral or anterior approaches to the brachial plexus. Potential adverse events associated with this technique include: Horner's syndrome, recurrent laryngeal nerve paralysis [12], unilateral phrenic nerve paralysis, subclavian artery injury [12], epidural placement [15], intrathecal injection of local anesthetic [16], and paralysis [16]. Although the patient had a BMI of 40 kg/ m 2 , we do not believe that it posed additional technical challenges or contributed to the catheter knotting.…”

Section: Discussionmentioning

confidence: 92%

Continuous cervical paravertebral catheter knot

Pulley

Spofford

Brennan

2010

Journal of Clinical Anesthesia

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Section: Discussionmentioning

confidence: 92%

Continuous cervical paravertebral catheter knot

Pulley

Spofford

Brennan

2010

Journal of Clinical Anesthesia

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“…Davon beschreiben 30 Fälle Symptome einer zervikalen Spinal-oder Epiduralanästhesie nach "Single-shot"-Injektion, die meistens ohne Spätfolgen blieben [1,2,9,18]; in 6 Fäl-len kam es jedoch zur Halsmarkläsion mit bleibenden neurologischen Schäden [3,15,19]. Die am häufigsten angewendete Punktionstechnik -soweit angegeben -war die nach Winnie [21].…”

Section: Diskussionunclassified

“…Injektionsschmerz wurde dabei nur selten angegeben [2]. Von 6 bekannten Halsmarkläsionen dagegen erfolgte nur eine Punktion beim wachen Patienten, und dieser gab dem Bericht zufolge direkt nach der Injektion von 40 ml LA akute Schmerzen im zu betäubenden Arm an, bevor er bewusstlos wurde [19]. Basierend auf diesen Kasuistiken rät die American Society of Regional Anesthesia and Pain Medicine speziell bei der ISRA von der Durchführung in Narkose oder tiefer Sedierung ab [14].…”

Section: Punktion In Narkoseunclassified

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Epidurale Fehllage eines interskalenären Plexuskatheters

Gaus¹,

Hess²,

Tanyay³

et al. 2011

Anaesthesist

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A patient received an interscalene plexus catheter before shoulder surgery. After induction of general anesthesia catheter placement was performed with Winnie's technique and 5 ml of ropivacaine was injected via the catheter. In the recovery room slight dyspnea without wheezing was observed which improved spontaneously. Following another bolus of ropivacaine, dyspnea and paralysis of the contralateral arm developed and the patient became hypotensive. The tomography scan showed epidural malpositioning of the catheter. Neuraxial complications of interscalene regional anesthesia are especially possible with medially directed insertion of the needle and have been described many times in the literature. The symptoms and recommendations for prevention are discussed.

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“…Our only way, therefore, of learning of these tragedies is from consistent reporting of cases, such as that reported by Voermans et al 6 The vast majority of these cases, unfortunately, enter the legal system and never reach our attention via the anesthesia literature or closed-claim studies, because most are settled out of court. Defense lawyers are reluctant to allow publication for fear of implicating or exposing their clients.…”

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confidence: 99%