Continuous Spinal Anesthesia After Unintentional Dural Puncture During Attempted Epidural Anesthesia for Mastectomy

2004 ◽  
Vol 29 (4) ◽  
pp. 381-382 ◽  
Author(s):  
Ertan Ozturk ◽  
Melis Gokce ◽  
Berrin Gunaydin ◽  
Avni Babacan
Keyword(s):  
Spinal Anesthesia ◽  
Epidural Anesthesia ◽  
Dural Puncture ◽  
Continuous Spinal Anesthesia

scholarly journals Continuous Spinal Anesthesia versus Combined Spinal Epidural Anesthesia for Major Orthopedic Hip Surgeries

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M S Abdelaziz ◽  
A N Elshaar ◽  
A E Elagamy ◽  
M A Ibrahim ◽  
M A Saleh
Keyword(s):  
Spinal Anesthesia ◽  
Epidural Anesthesia ◽  
Hip Replacement ◽  
Sensory Block ◽  
Continuous Spinal Anesthesia ◽  
Combined Spinal Epidural ◽  
Significant Difference ◽  
Post Operative Nausea ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural

Abstract Background hip replacement surgery is common among elderly patients. These patients have increased risk for perioperative mortality and morbidity due to additional comorbidities, such as cardiac, endocrine, renal, cerebral and respiratory diseases. Aim of the Work to compare between continuous spinal anesthesia and combined spinal epidural anesthesia in patients scheduled for elective major hip surgeries as regards their effectiveness and possible complications during operation. Patients and Methods after obtaining the approval of the ethical committee of faculty of medicine, Ain-Shams University, and patients’ written informed consents, this prospective randomized clinical trial study was conducted at Ain Shams University Hospitals at the orthopedics operating theatre. Seventy two patients aged older than 30 years, of both sexes and American Society of Anesthesiologists (ASA) class I, II, scheduled for elective major hip surgeries like total hip replacement or hemi arthroplasty were included in the study. All Patients were assigned randomly by using a computer generated program with closed envelops to one of the two equal groups:CSAgroup(36)patient and CSEgroup(36)patient. Results there was no statistically significant differences between the CSA and CSE groups as regards demographic data; Age, Sex or BMI. Baseline HR was similar in both groups. The heart rate was significantly higher in the CSE group at 5 min and 15 min when compared to CSA group. The mean blood pressure was significantly lower in group CSE at 5min anf 15 min when compared to CSA group.The total dose of bupivacaine 0.5% mg collectively given was much lower in the CSA group than the CSE group. The onset of sensory block (time between the end of injection and the time to reach T10sesnsory level) and degree of motor block between two groups showed no statistically significant difference but the level of sensory block was significantly higher in CSE group than CSA group.there was no significant difference as regard PDPH, Post operative nausea and vomiting, Bradycardia but there was significant difference as regard incidence of hypotension being higher in CSE group than CSA group. The time of first analgesic request showed no significant difference between the two groups Conclusion both continuous spinal anesthesia and compined spinal epidural anesthesia are safe anesthetic techniques for lower limb surgeries. CSA offers possibilities of more hemodynamic stability with smaller doses of local anesthetics than CSE with rapid onset of sensory block and good extendede post operative analgesia.

scholarly journals Continuous Spinal Anesthesia following Inadvertent Dural Puncture during Epidural Placement for an Emergency Laparotomy

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Andrew Emyedu ◽  
Bernadette Kyoheirwe ◽  
Patience Atumanya
Keyword(s):  
Spinal Anesthesia ◽  
Dural Puncture ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Emergency Laparotomy ◽  
Continuous Spinal Anesthesia ◽  
Accident And Emergency ◽  
Accidental Dural Puncture ◽  
History Of ◽  
Intrathecal Space

Summary. Emergency exploratory laparotomy conducted under continuous spinal anesthesia using a standard epidural set following an accidental dural puncture. Background and Objectives. Continuous spinal anesthesia is one of the least utilized regional anesthesia techniques globally. It could be an alternative anesthesia technique for abdominal and lower limb surgeries following an accidental dural puncture. The aim of this report was to describe a case in which continuous spinal anesthesia was successfully conducted for emergency exploratory laparotomy following an accidental dural puncture during epidural placement. Case Report. A 38-year-old male presented to our accident and emergency unit with a one-day history of colicky abdominal pain associated with constipation, abdominal distension, and vomiting. He was diagnosed with intestinal obstruction and underwent an emergency exploratory laparotomy under continuous spinal anesthesia using a standard epidural set following an accidental dural puncture. Conclusion. This case demonstrates that in case of an accidental dural puncture during epidural placement, the catheter can be advanced into the intrathecal space and continuous spinal anesthesia conducted for abdominal surgeries using a standard epidural catheter.

scholarly journals Unexpected High Sensory Blockade during Continuous Spinal Anesthesiology (CSA) in an Elderly Patient

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
R. Ketelaars ◽  
A. P. Wolff
Keyword(s):  
Elderly Patient ◽  
Spinal Anesthesia ◽  
Dural Puncture ◽  
Postanesthesia Care Unit ◽  
Continuous Spinal Anesthesia ◽  
Sensory Blockade ◽  
Post Dural Puncture Headache ◽  
Anesthetic Agents ◽  
Anesthesia Technique ◽  
Spinal Catheter

A 98-year-old woman presented for a hemiarthroplasty of the left hip. Because of her age and cardiac and pulmonary co-existing diseases we decided to provide adequate regional anesthesia by continuous spinal anesthesia. Fragmented doses of isobaric bupivacaine 0.5% were administered through a system consisting of a spinal catheter connected to an antimicrobial filter. After an uneventful surgical procedure, prior to removal of the catheter, this system was flushed with 10 mL of normal saline in order to try to prevent post-dural-puncture headache. After arrival at the postanesthesia care unit and fifteen minutes after removal of the catheter the patient suffered an unexpected high thoracic sensory blockade and hypotension requiring treatment. The continuous spinal anesthesia technique can be used in selected cases to be able to administer local anesthetic agents in a slow and controlled manner to reach the desired effect. The risk of post-dural-puncture headache using this technique in elderly patients is very low and therefore precludes the need to try to prevent it. We have described a potentially dangerous complication of flushing a bupivacaine-filled system into the spinal canal of an elderly patient resulting in an undesirable high sensory blockade.

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