Percutaneous Nephrolithotomy Under General Versus Combined Spinal-Epidural Anesthesia

2009 ◽  
Vol 23 (11) ◽  
pp. 1835-1838 ◽  
Author(s):  
Baris Kuzgunbay ◽  
Tahsin Turunc ◽  
Sule Akin ◽  
Pinar Ergenoglu ◽  
Anis Aribogan ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Epidural Anesthesia ◽  
Combined Spinal Epidural ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural

scholarly journals Spinal subdural hematoma and subdural anesthesia following combined spinal–epidural anesthesia: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yanmei Bi ◽  
Junying Zhou
Keyword(s):  
Epidural Anesthesia ◽  
Subdural Hematoma ◽  
Cauda Equina ◽  
Vital Signs ◽  
Epidural Administration ◽  
Single Shot ◽  
Combined Spinal Epidural ◽  
Spinal Subdural Hematoma ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural

Abstract Background Subdural anesthesia and spinal subdural hematoma are rare complications of combined spinal-epidural anesthesia. We present a patient who developed both after multiple attempts to achieve combined spinal–epidural anesthesia. Case presentation A 21-year-old parturient, gravida 1, para 1, with twin pregnancy at gestational age 34+ 5 weeks underwent cesarean delivery. Routine combined spinal–epidural anesthesia was planned; however, no cerebrospinal fluid outflow was achieved after several attempts. Bupivacaine (2.5 mL) administered via a spinal needle only achieved asymmetric blockade of the lower extremities, reaching T12. Then, epidural administration of low-dose 2-chlorprocaine caused unexpected blockade above T2 as well as tinnitus, dyspnea, and inability to speak. The patient was intubated, and the twins were delivered. Ten minutes after the operation, the patient was awake with normal tidal volume. The endotracheal tube was removed, and she was transferred to the intensive care unit for further observation. Postoperative magnetic resonance imaging suggested a spinal subdural hematoma extending from T12 to the cauda equina. Sensory and motor function completely recovered 5 h after surgery. She denied headache, low back pain, or other neurologic deficit. The patient was discharged 6 days after surgery. One month later, repeat MRI was normal. Conclusions All anesthesiologists should be aware of the possibility of SSDH and subdural block when performing neuraxial anesthesia, especially in patients in whom puncture is difficult. Less traumatic methods of achieving anesthesia, such as epidural anesthesia, single-shot spinal anesthesia, or general anesthesia should be considered in these patients. Furthermore, vital signs and neurologic function should be closely monitored during and after surgery.

Combined spinal epidural anesthesia in obese parturients undergoing cesarean surgery

2021 ◽  
Author(s):  
Fatma Okucu ◽  
Mehmet Aksoy ◽  
Ilker Ince ◽  
Ayse Nur Aksoy ◽  
Aysenur Dostbıl ◽  
...  
Keyword(s):  
Epidural Anesthesia ◽  
Combined Spinal Epidural ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural
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