Zespół wielokorzeniowy i zapalenie opon mózgowo-rdzeniowych jako powikłania znieczulenia podpajęczynówkowego – opis przypadków

*Marcin Owczarek, Waldemar Iwańczuk

Summary
Background. Spinal block is a safe method of regional anaesthesia, nevertheless some complications may occur. We describe two cases of elective spinal anaesthesia, complicated by a transient radicular lesion and meningitis.
Case 1. A 15-year-old girl received intrathecally 3 ml of 0.5% heavy bupivacaine for elective orthopaedic surgery. During injection, she reported strong paraesthesias in the left leg. The surgery proceeded uneventfully, but on the next day, the patient complained about sensory loss in her left foot and paresis of the left peroneal nerve. Immediate MRI did not reveal any pathology and her symptoms resolved spontaneously within 8 days.
Case 2. A 23-year-old man developed meningitis (GSG 9, opisthotonus, hyper-reactivity, and bilateral Babinski sign) on the day after spinal anaesthesia for arthroscopy. Spinal fluid examination revealed increased protein concentration, presence of leucocytes, and decreased glucose concentration. A CT scan showed mild cerebral oedema, and spinal fluid culture was negative. The patient received cefotaxim, penicillin G and amikacin, and he recovered after 14 days of antimicrobial therapy.
Discussion. Although the risk of severe postoperative neurologic dysfunction in patients undergoing neuraxial anesthesia is low, clinicians should be aware of the possibility. Both cases, in which the exact causes of the complications have been difficult to define, are discussed in detail.

To jest tylko fragment artykułu. Aby przeczytać całość, przejdź do Czytelni medycznej.