Abstract:SummaryFatal oesophageal perforation occurred as a complication of elective general anaesthesia for cataract extraction in a 77-year-old female patient. Tracheal intubation had been achieved, albeit with difficulty, in the course of a clinical trial of the intubating laryngeal mask.Keywords Equipment; intubating laryngeal mask. Complications. ...................................................................................... Correspondence to: Dr M. A. Branthwaite Accepted: 30 May 1998 The laryngeal ma… Show more
“…Moreover, at least some of these complications have been reported after LOR to saline. 16 We did find a small but statistically significant increase in the number of attempts required to locate the epidural space with LOR to air compared with saline. There are several possible explanations.…”
When used at the anesthesiologist's discretion, there is no significant difference in block success between air and saline for localization of the epidural space by LOR.
“…Moreover, at least some of these complications have been reported after LOR to saline. 16 We did find a small but statistically significant increase in the number of attempts required to locate the epidural space with LOR to air compared with saline. There are several possible explanations.…”
When used at the anesthesiologist's discretion, there is no significant difference in block success between air and saline for localization of the epidural space by LOR.
“…Epidural air can spread along the nerves of the paravertebral space, and, depending on its location, neurologic complications such as multiradicular syndrome, lumbar root compression, and even paraplegia can occur [7,8]. Kennedy et al [8] reported a case of back pain and paraplegia due to an erroneous injection of massive air in the epidural space during continuous lumbar epidural infusion of opioids and local anesthetics to treat cancer pain.…”
Air injected into the epidural space may spread along the nerves of the paravertebral space. Depending on the location of the air, neurologic complications such as multiradicular syndrome, lumbar root compression, and even paraplegia may occur. However, cases of motor weakness caused by air bubbles after caudal epidural injection are rare. A 44-year-old female patient received a caudal epidural injection after an air-acceptance test. Four hours later, she complained of motor weakness in the right lower extremity and numbness of the S1 dermatome. Magnetic resonance imaging showed no anomalies other than an air bubble measuring 13 mm in length and 0.337 ml in volume positioned near the right S1 root. Her symptoms completely regressed within 48 hours.
“…The most common etiology in these symptomatic cases was diagnostic or anesthetic intervention to the spine (n ¼ 8). 18,[30][31][32][33][34][35][36] Neurologic symptoms in four patients were associated with pneumothorax or pneumomediastinum caused by thorax trauma and lobectomy for small-cell carcinoma of the lung. 20,[37][38][39] Two patients' neurologic symptoms were associated with pneumocephalus caused by head trauma and a suboccipital craniotomy for foramen magnum meningioma, respectively.…”
Section: Symptomatologymentioning
confidence: 99%
“…Recent studies have shown that PR itself can cause neurologic symptoms ranging from radicular pain to cauda equina syndrome. [30][31][32][33][34][35] A literature search disclosed 19 cases in which the patient exhibited one or more symptoms. Of these 19 patients, 10 presented with weakness, 7 with sensory loss, and 7 with radicular pain (►Table 1).…”
Pneumorrhachis (PR) is the presence of air within the spinal canal, whether localized in the epidural or in the subarachnoid space. Evidence of intraspinal air, especially in the subarachnoid space, had been thought to be merely a radiological artifact of serious underlying pathology until it was proven that PRs can be related to neurologic symptoms ranging from radicular pain to serious neurologic deficits. The etiologies, pathomechanisms, and natural courses show differences from case to case, with the result that no consistent treatment strategies exist in the literature. Although the conservative treatment modalities seem to be more appropriate in nonsymptomatic cases, treatment strategies in symptomatic cases remain the subject of discussion. In this study, we present two symptomatic cases of PR arising from different causes and review the literature, focusing especially on the symptomatic cases and strategies for treating them.
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