scholarly journals A case of spinal nerve neurotoxicity with ropivacaine after combined spinal and epidural anesthesia

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Tsukasa Shimauchi ◽  
Jun Yoshino ◽  
Naoyuki Fujimura
Keyword(s):  
Case Report ◽  
Epidural Anesthesia ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Recovery Process ◽  
Spinal Nerve ◽  
Careful Monitoring ◽  
Emergency Cesarean ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural

Abstract Background Neurotoxicity caused by a local anesthetic after regional anesthesia is a rare but serious problem for anesthesiologists. It is difficult to diagnose neurotoxicity from anesthetics because of the large number of possible diagnoses. In this case report, careful monitoring by neurological examinations helped to diagnose local neurotoxicity caused after epidural anesthesia. Case description A 41-year-old pregnant woman who underwent emergency cesarean delivery under combined spinal-epidural anesthesia suffered left leg paralysis after surgery. Multiple neurological examinations (e.g., electromyography, nerve conduction study) revealed that the paralysis was induced by the neurotoxicity of ropivacaine. The neurological examinations were also useful to monitor the recovery process. Conclusions This is the first clinical case report that describes the diagnosis of and recovery from local anesthesia-induced neurotoxicity monitored by electromyography and nerve conduction study. Neurological disorders caused by regional anesthetics should be carefully examined and diagnosed using these neurological examinations.

Acute Dystonia after a Single Dose of Intravenous Metoclopramide during Elective Cesarean Section: A Case Report.

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Danielle Levin
Keyword(s):  
Single Dose ◽  
Case Report ◽  
Cesarean Section ◽  
Epidural Anesthesia ◽  
Elective Cesarean Section ◽  
Single Administration ◽  
Dystonic Reaction ◽  
Elective Cesarean ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural

We would like to present the first report of severe acute dystonic reaction after a single administration of metoclopramide during cesarean section under combined spinal-epidural anesthesia.  During elective cesarean section, a 30-year-old female vomited four times and was treated with 10mg intravenous metoclopramide and 8mg intravenous ondansetron.  Nausea subsided with the antiemetic treatment, but two minutes later, patient had rapid eye blinking, uncontrollable head movement, and became unresponsive.  Bolus of 50mg intravenous diphenhydramine resolved the acute dystonic symptoms within seconds.  Patient was again oriented times three, with no recollection of symptoms, and remained symptom free for the rest of admission. 

Optimal Anesthesia Scheme for Transfer to Emergency Cesarean Section in Failed Labor Analgesia Trial Delivery

2021 ◽  
Author(s):  
Wen-hao Bu ◽  
Wei Wu ◽  
Na Li ◽  
Lin Chen ◽  
Lin-li Yue
Keyword(s):  
Cesarean Section ◽  
Epidural Anesthesia ◽  
Vital Signs ◽  
Labor Analgesia ◽  
Emergency Cesarean Section ◽  
Combined Spinal Epidural ◽  
Emergency Cesarean ◽  
The Difference ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural

Abstract Objective： To explore the optimal anesthetic method of transferring to emergency cesarean section after the failure of labor analgesia. Methods: A retrospective study included 1154 patients who underwent cesarean section in Hubei Maternal and Child Health Hospital from January 2019 to January 2020, of which 586 patients were transferred to cesarean section after labor analgesia, They were divided into two groups according to the method of anesthesia: Epidural labor analgesia / Epidural anesthesia (ELA/EA) group : After the failure of natural labor during labor analgesia, local anesthetics continue to be added to the epidural(n=282);Epidural labor analgesia/Combined spinal and epidural anesthesia(ELA/CSEA) group: Combined spinal-epidural anesthesia was performed after spontaneous labor failure during epidural labor analgesia(n=304); Combined spinal and epidural anesthesia(CSEA) group: Patients who undergo emergency cesarean section without labor analgesia(n=568). The case data were reviewed and the anesthetic methods, basic vital signs, medication, time, maternal and infant outcome of the three groups were descriptively analyzed. Results: There was a difference in the time of admission to neonatal delivery, the maximum decrease of diastolic blood pressure and the difference of neonatal 1min apgar score between ELA/EA group and ELA/CSEA group. There was a difference in the dosage of spinal anesthesia between ELA/CSEA group and CSEA group. Conclusion: When the obstetrician anesthesiologist fails during labor analgesia and needs to be transferred to cesarean section, they can choose to re-perform combined spinal-epidural anesthesia, which is beneficial to the early outcome of newborns, but the long-term effect on newborns needs to be further studied.

scholarly journals Thoracic combined spinal-epidural anesthesia for laparoscopic cholecystectomy in an obese patient with asthma and multiple drug allergies: a case report

2016 ◽  
Vol 1 (2) ◽  
pp. 105-108
Author(s):  
Andrzej Daszkiewicz ◽  
Maja Copik ◽  
Hanna Misiolek
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Obese Patient ◽  
Regional Anesthesia ◽  
Epidural Anesthesia ◽  
Multiple Drug ◽  
Combined Spinal Epidural ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural

AbstractDrug allergies, asthma, and obesity are more common in modern societies, and patients with these problems are often a challenge for anesthetists. Different techniques of regional anesthesia can be beneficial particularly for this group of patients. We present a patient who suffered from all of the above-mentioned conditions and successfully underwent laparoscopic cholecystectomy under thoracic combined spinal-epidural anesthesia. It is still not a popular practice, and we would like to show another indication for using it.

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