A case of cerebrospinal fluid leak in an infant after spinal anesthesia - 18/05/13
Abstract |
A 2 month old, 51 kg female infant underwent neuraxial anesthesia for repair of a right inguinal hernia. After two unsuccessful attempts at obtaining free-flowing cerebrospinal fluid (CSF) in the L3-L4 lumbar interspace with a 25-gauge (G) neonatal spinal needle, clear CSF was obtained using a Quincke 22-G needle. After easy aspiration, a total of 0.7 mL of 0.75% hyperbaric bupivicaine was injected intrathecally. Immediately after the spinal block, a caudal epidural block was placed by injecting 2 mL of 0.25% bupivacaine with 1:200,000 using a 22-G Quincke spinal needle. Surgery and recovery were uneventful. Two days later, after a crying spell, a bulging, grape size swelling was noted in the infant’s lumbar region. Examination was normal except that her fontanel was mildly depressed when she was upright, and a 1 - 1.5 cm soft, nontender swelling in her lumbar area bulged out when she strained. The bulge resolved over the next 48 hours. In the majority of neonates, CSF leaks into the epidural space after lumbar puncture. In our case, the patient showed CSF accumulation at the site of puncture.
Le texte complet de cet article est disponible en PDF.Keywords : Anesthesia, Pediatric, Cerebral spinal fluid, Infant, Spinal anesthesia: Complication
Plan
☆ | None of the authors has any financial relationships related to this publication. |
☆☆ | Presented in part at the Winter Meeting of the Society for Pediatric Anesthesia/American Academy of Pediatrics (SPA/AAP), Tampa, FL, Feb. 23-26, 2012. |
Vol 25 - N° 3
P. 217-219 - mai 2013 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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