Total Spinal Anesthesia, A Late Complication of Epidural Anesthesia

Woerth, Stanley D.; Bullard, John; Alpert, Calvert C.

doi:10.1097/00000542-197710000-00011

Cited by 12 publications

(2 citation statements)

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“…The possibility of total spinal anesthesia following epidural analgesia also needs to be ruled out. Total spinal anesthesia causes sudden physiological changes by blocking the peripheral nerves, including the spinal cord and cranial nerve [16]. Because both patients came from local pain clinics, there was insufficient information to investigate this possibility; including the patients’ position, location of injection, type or size of needle, and number of attempts.…”

Section: Discussionmentioning

confidence: 99%

Cardiac arrest associated with pneumorrhachis and pneumocephalus after epidural analgesia: two case reports

et al. 2018

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BackgroundEpidural analgesia has become a common procedure to provide excellent pain relief with few complications. Pneumorrhachis and pneumocephalus are rare complications of unintentional dural puncture and injection of air into the subarachnoid or subdural space. No cases of cardiac arrest associated with these complications have been reported in the literature previously.Case presentationWe report cases of pneumorrhachis and pneumocephalus in two Korean women who previously visited a local pain clinic and underwent epidural analgesia. Thereafter, they were admitted to the emergency department with cardiac arrest. Cardiopulmonary resuscitation was performed on these patients, and return of spontaneous circulation was achieved. The brain and spine computed tomographic scans showed pneumorrhachis and pneumocephalus, respectively. These cases demonstrate that pneumorrhachis and pneumocephalus may occur after epidural analgesia, which may be associated with cardiac arrest in patients.ConclusionsIf cardiac arrest occurs after epidural analgesia, pneumocephalus and pneumorrhachis should be considered as its cause. Although epidural analgesia is a common procedure, caution is warranted during this procedure.

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Section: Discussionmentioning

confidence: 99%

Cardiac arrest associated with pneumorrhachis and pneumocephalus after epidural analgesia: two case reports

et al. 2018

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“…Furthermore, previous reports of total spinal anesthesia produced by unintentional dural puncture during attempted epidural anesthesia noted that it had produced only transient effects with no apparent neurological sequelae. [14][15][16] Why then did serious neurological sequelae result in the patients reported in the 3 publications alluded to above?…”

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confidence: 99%