Spinal Anesthesia, Arachnoiditis, and Paraplegia

Joseph, Samuel I.

doi:10.1001/jama.1958.03000100032007

Cited by 16 publications

(3 citation statements)

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“…Two animals had severe histological changes, but only one of them had clinical symptoms of the disease. 32 Similar results were found by different researchers using different animal models, where clinical findings did not relate to the degree of histological changes. 20,33,34 As AA develops very slowly, the neurological symptoms may be present only after a long period of evolution, reason perhaps the dogs in this study did not present any clinical findings during the experimental period of 21 days.…”

Section: Discussionsupporting

confidence: 85%

The effects of intrathecal administration of betamethasone over the dogs' spinal cord and meninges

2007

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Purpose:To determinate the potential clinical and histological changes due the injection of betamethasone, when administered into the canine intrathecal space. Methods: Twenty one animals were included in a random and blind manner in the study. After general anesthesia, intrathecal puncture was performed and 1 ml of the random solution was injected. The G1 dogs received 0.9% saline solution, the G2 dogs received 1.75 mg betamethasone and the G3 dogs received 3.5 mg of betamethasone. The animals were clinically evaluated for 21 days and then sacrificed. The lumbar and sacral portions of the spinal cord were removed for light microscopy histological analyses. Results: No clinical changes were observed in any of the animals included in this study. No histological changes were observed in G1 animals. Inflammatory infiltration was observed in two dogs, one in G2, another in G3. Hemorrhage and necrosis were also seen in the G2 dog which inflammatory infiltration was detected. In other two dogs, one from G2 and another from G3, there was discreet fibrosis and thickness of the arachnoid layer which was focal in one and diffuse in the other. Conclusion: Intrathecal administration of betamethasone caused histological changes in the spinal cord and meninges in some of the dogs involved in this study. Key words: Adrenal Cortex Hormones. Betamethasone. Toxicity. Arachnoiditis. Dogs. RESUMOObjetivo: Determinar possíveis alterações clínicas e histológicas determinadas pela administração da betametasona no espaço subaracnóideo de cães. Métodos: Vinte e um cães foram incluídos no estudo de forma aleatória e encoberta. Depois de anestesiados, os cães foram submetidos a punção subaracóidea com injeção de 1 ml da solução sorteada. Os animais receberam solução salina 0,9% em G1, betametasona na dose de 1,75 mg em G2 e betametasona na dose de 3,5 mg em G3. Todos os animais foram mantidos em observação clínica por 21 dias, sendo posteriormente sacrificados. Porções da medula espinhal e sacral foram removidas para análise histológica por microscopia óptica. Resultados: Não foram detectadas alterações clínicas em quaisquer dos animais incluídos no estudo. Da mesma forma, nenhum animal do G1 apresentou alterações histológicas. Infiltração inflamatória foi observada em dois cães, um do G2 e outro e G3. No cão do G2 onde a infiltração inflamatória foi observada ocorreu, conjuntamente, hemorragia e necrose. Em dois cães, um de G2 e outro de G3, observou-se discreta fibrose e espessamento da aracnóide, sendo focal em um e difusa no outro. Conclusão: A administração subaracnóidea de betametasona determinou alterações histológicas em medula e meninges de alguns dos cães envolvidos no estudo.

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Section: Discussionsupporting

confidence: 85%

The effects of intrathecal administration of betamethasone over the dogs' spinal cord and meninges

2007

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“…It is still uncertain whether complications affecting the meninges are due to the concentration of the local anaesthetic agent or to an irritative action of a detergent or other neurotoxic compound. 74,77 There is little doubt that most of the cases of adhesive arachnoiditis and paraplegia which have been attributed to spinal anaesthesia were due to various errors in its administration. This has been demonstrated conclusively by investigative work in animals.…”

Section: Ma/or Neurological Complicationsmentioning

confidence: 99%

Modern trends in spinal anaesthesia

Lund

Cwik

1968

Can. Anaes. Soc. J.

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“…Chemical contaminants were experimentally shown 12 to be able to produce severe arachnoiditis and clinical paraplegia in monkeys and could be the causal agent in some clinical situations. Increased concentration of the anes thetic agent was also demonstrated to produce, in experimental animals, neurologic syndromes similar to the observed in clinical situations 16 > 17 .…”

mentioning

confidence: 99%

Paraplegia and intracranial hypertension following epidural anesthesia: report of four cases

Kliemann

1975

Arq. Neuro-Psiquiatr.

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Spinal Anesthesia, Arachnoiditis, and Paraplegia

Cited by 16 publications

References 3 publications

The effects of intrathecal administration of betamethasone over the dogs' spinal cord and meninges

The effects of intrathecal administration of betamethasone over the dogs' spinal cord and meninges

Modern trends in spinal anaesthesia

Paraplegia and intracranial hypertension following epidural anesthesia: report of four cases

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