Persistent paralysis after spinal anesthesia for cesarean delivery
Anterior spinal artery syndrome has rarely been reported as a cause of permanent neurologic complications after neuraxial anesthesia in obstetric patients. A parturient developed anterior spinal artery syndrome after spinal anesthesia for cesarean delivery. A healthy 32-year-old parturient presented at 41(2/7) weeks for primary elective caesarean delivery for breech presentation. Spinal anesthesia was easily performed with clear cerebrospinal fluid, and block height was T4 at 5 minutes. Intraoperative course was uneventful except for symptomatic bradycardia (37-40 beats per minute) and hypotension (88/44 mm Hg) 4 minutes postspinal anesthesia, treated with ephedrine and atropine. Dense motor block persisted 9 hours after spinal anesthesia, and magnetic resonance imaging of the lumbosacral region was normal, finding no spinal cord compression or lesion. Physical examination revealed deficits consistent with a spinal cord lesion at T6, impacting the anterior spinal cord while sparing the posterior tracts..
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
2015 |
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| Erschienen: |
2015 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:27 |
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| Enthalten in: |
Journal of clinical anesthesia - 27(2015), 1, Seite 68-72 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zaphiratos, Valerie [VerfasserIn] |
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| Links: |
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| doi: |
10.1016/j.jclinane.2014.08.003 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
OLC1958095397 |
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| 245 | 1 | 0 | |a Persistent paralysis after spinal anesthesia for cesarean delivery |
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| 520 | |a Anterior spinal artery syndrome has rarely been reported as a cause of permanent neurologic complications after neuraxial anesthesia in obstetric patients. A parturient developed anterior spinal artery syndrome after spinal anesthesia for cesarean delivery. A healthy 32-year-old parturient presented at 41(2/7) weeks for primary elective caesarean delivery for breech presentation. Spinal anesthesia was easily performed with clear cerebrospinal fluid, and block height was T4 at 5 minutes. Intraoperative course was uneventful except for symptomatic bradycardia (37-40 beats per minute) and hypotension (88/44 mm Hg) 4 minutes postspinal anesthesia, treated with ephedrine and atropine. Dense motor block persisted 9 hours after spinal anesthesia, and magnetic resonance imaging of the lumbosacral region was normal, finding no spinal cord compression or lesion. Physical examination revealed deficits consistent with a spinal cord lesion at T6, impacting the anterior spinal cord while sparing the posterior tracts. | ||
| 540 | |a Nutzungsrecht: Copyright © 2014 Elsevier Inc. All rights reserved. | ||
| 650 | 4 | |a Anesthesia, Spinal - adverse effects | |
| 650 | 4 | |a Anesthesia, Obstetrical - adverse effects | |
| 650 | 4 | |a Anterior Spinal Artery Syndrome - complications | |
| 650 | 4 | |a Cesarean Section - methods | |
| 650 | 4 | |a Paralysis - chemically induced | |
| 650 | 4 | |a Ephedrine - administration & dosage | |
| 650 | 4 | |a Anterior Spinal Artery Syndrome - chemically induced | |
| 650 | 4 | |a Anesthesia, Spinal - methods | |
| 650 | 4 | |a Anesthesia, Obstetrical - methods | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Cesarean delivery | |
| 650 | 4 | |a Coronary vessels | |
| 650 | 4 | |a Spinal anesthesia | |
| 650 | 4 | |a Nuclear magnetic resonance--NMR | |
| 650 | 4 | |a Spinal cord | |
| 650 | 4 | |a Abdomen | |
| 650 | 4 | |a Ischemia | |
| 650 | 4 | |a Adverse outcome | |
| 650 | 4 | |a Neuraxial anesthesia | |
| 650 | 4 | |a Neurologic complication | |
| 650 | 4 | |a Paralysis | |
| 650 | 4 | |a Anesthesia | |
| 650 | 4 | |a Surgery | |
| 650 | 4 | |a Paralysis/paraplegia | |
| 650 | 4 | |a Veins & arteries | |
| 650 | 4 | |a Obstetrics | |
| 650 | 4 | |a Anterior spinal artery syndrome | |
| 700 | 1 | |a McKeen, Dolores M |4 oth | |
| 700 | 1 | |a Macaulay, Bruce |4 oth | |
| 700 | 1 | |a George, Ronald B |4 oth | |
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| 773 | 1 | 8 | |g volume:27 |g year:2015 |g number:1 |g pages:68-72 |
| 856 | 4 | 1 | |u http://dx.doi.org/10.1016/j.jclinane.2014.08.003 |3 Volltext |
| 856 | 4 | 2 | |u http://www.ncbi.nlm.nih.gov/pubmed/25433726 |
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