Prolonged post spinal anaesthesia paralysis

Syal, Kartik; Sood, Anil K.; Bhatt, Rashmi; Gupta, Hemlata

doi:10.4103/0019-5049.158757

Cited by 2 publications

(1 citation statement)

References 8 publications

(9 reference statements)

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“…The incidence of hematoma is <1 in 150,000 epidurals and 1 in 220,000 following spinal anesthesia. [ 52 53 ] Vascular malformations and anticoagulant therapy with increased pressure in the vertebral venous plexus are some of the common causative factors. The diagnosis is established by magnetic resonance imaging (MRI) followed by surgical decompression.…”

Section: Regional Anesthesiamentioning

confidence: 99%

Delayed recovery from anesthesia: A postgraduate educational review

2016

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Delayed awakening from anesthesia remains one of the biggest challenges that involve an anesthesiologist. With the general use of fast-acting anesthetic agents, patients usually awaken quickly in the postoperative period. The time to emerge from anesthesia is affected by patient factors, anesthetic factors, duration of surgery, and painful stimulation. The principal factors responsible for delayed awakening following anesthesia are anesthetic agents and medications used in the perioperative period. Nonpharmacological causes may have a serious sequel, hence recognizing these organic conditions is important. Certain underlying metabolic disorders such as hypoglycemia, severe hyperglycemia, and electrolyte imbalance, especially hypernatremia, hypoxia, hypercapnia, central anticholinergic syndrome, chronic hypertension, liver disease, hypoalbuminemia, uremia, and severe hypothyroidism may also be responsible for delayed recovery following anesthesia. Unexpected delayed emergence after general anesthesia may also be due to intraoperative cerebral hypoxia, hemorrhage, embolism, or thrombosis. Accurate diagnosis of the underlying cause is the key for the institution of appropriate therapy, but primary management is to maintain airway, breathing, and circulation. This comprehensive review discusses the risk factors, causes, evaluation and management of delayed recovery based on our clinical experience, and literature search on the internet, supported by the standard textbooks of anesthesiology.

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Section: Regional Anesthesiamentioning

confidence: 99%

Delayed recovery from anesthesia: A postgraduate educational review

2016

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Spinal anesthesia in a patient on monoclonal antibody treatment: a poisoned chalice? A case report

Herijgers

Dyck

Leroy

et al. 2021

Reg Anesth Pain Med

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BackgroundParaplegia is a rare complication of spinal anesthesia.Case presentationWe report a case of a 68-year-old man who developed postoperative paraplegia and hypoesthesia after spinal anesthesia for an otherwise uncomplicated transurethral resection of the prostate. Acute transverse myelitis was diagnosed based on urgent MRI. A prior history of similar though less severe neurological symptoms after obinutuzumab treatment for follicular lymphoma suggested a potential causative role for obinutuzumab, a novel monoclonal antibody that has not been associated with such devastating neurological side effects yet. High-dose steroid treatment partially attenuated the symptoms, but debilitating hypoesthesia and motor deficit remained present 3 months postoperatively.ConclusionThe presented case warrants caution when performing neuraxial anesthesia in patients on monoclonal antibody therapies.

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Prolonged post spinal anaesthesia paralysis

Cited by 2 publications

References 8 publications

Delayed recovery from anesthesia: A postgraduate educational review

Delayed recovery from anesthesia: A postgraduate educational review

Spinal anesthesia in a patient on monoclonal antibody treatment: a poisoned chalice? A case report

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