Cauda equina syndrome following an uneventful spinal anaesthesia

Jain, Mamta; Srivastava, Uma; Saxena, Sonal; Singh, Anish Kumar; Kumar, Aditya

doi:10.4103/0019-5049.60505

Cited by 12 publications

(10 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, one study claimed that addition of adjuvants had caused reduction in duration of the block. 21 As regard sensorimotor blockade characteristics, current study results demonstrated a quality improvement in SA when adjuvants were added to LA. Time to onset of sensory and motor blocks was shorter in adjuvant groups than controls with comparable differences between fentanyl and nalbuphine.…”

Section: Discussionmentioning

confidence: 58%

Intrathecal midazolam is a comparable alternative to fentanyl and nalbuphine as adjuvant to bupivacaine in spinal anesthesia for elective Cesarean Section; a randomized controlled double-blind trial

Amin

Souidan

Abdelzaam

2023

Anaesth. pain intensive care

View full text Add to dashboard Cite

Background: Different adjuvants have been introduced to enhance the quality of local anesthetics and reduce its adverse events. This study was directed to compare the anesthetic and analgesic properties of intrathecal hyperbaric bupivacaine when three different adjuvant drugs were added. Methodology: One hundred full-term parturients aged 18 to 40 years, scheduled for elective cesarean section, were randomly assigned to 4 groups. Each group received 12.5 mg of 0.5% hyperbaric bupivacaine combined with either 0.5 ml saline (Group-B), 25µg fentanyl (Group-F), 0.8 mg nalbuphine (Group-N) or 2 mg midazolam (Group-M). The outcomes included the postoperative effective analgesia time, the sensorimotor characteristics, postoperative VAS score, pethidine consumption, maternal complications, and neonatal Apgar score. Results: Earlier onset of sensory and motor block was observed in Group F and N than in Group B and M. Duration of postoperative effective analgesia was longer in Groups F, N and M (252.42 ± 46.11, 227.34 ± 36.54 and 243.71 ± 44.95 hours, respectively) than in Group B (172.11 ± 20.99) (P < 0.001). VAS scores decreased in adjuvant groups during the first 12 hours postoperative and required pethidine doses were less. Conclusion: Addition of adjuvant agents to intrathecal bupivacaine improved the quality of subarachnoid block without increasing side-effects. Intrathecal midazolam provided comparable outcomes as the frequently used opioids. Abbreviations: CS: Cesarean section; LA: Local anesthetics; SA: Spinal anesthesia Key words: Intrathecal; Nalbuphine; Midazolam; Fentanyl; Postoperative analgesia; Cesarean section. Citation: Amin SR, Souidan I, Abdelzaam EM. Intrathecal midazolam is a comparable alternative to fentanyl and nalbuphine as adjuvant to bupivacaine in spinal anesthesia for elective cesarean section: a randomized controlled double-blind trial. Anaesth. pain intensive care 2022;27(1):89−96; DOI: 10.35975/apic.v27i1.1923 Received: June 26, 2022; Reviewed: November 28, 2022; Accepted: December 14, 2022

show abstract

Section: Discussionmentioning

confidence: 58%

Intrathecal midazolam is a comparable alternative to fentanyl and nalbuphine as adjuvant to bupivacaine in spinal anesthesia for elective Cesarean Section; a randomized controlled double-blind trial

Amin

Souidan

Abdelzaam

2023

Anaesth. pain intensive care

View full text Add to dashboard Cite

show abstract

“…Cauda equine syndrome ranges from mild form to severe form, which results in transient or permanent bladder dysfunction with motor and sensory loss. 9 Local anesthetic dose and potency were related to duration of detrusor dysfunction. 1 Local anesthetics capable of inducing long-lasting structural and functional changes in neural tissue in a large dose, the sensation of bladder fullness was decreased with opioids.…”

Section: Discussionmentioning

confidence: 99%

Transient bladder incontinence following ultrasound guided caudal epidural block

Rajasekaran

Bokka

2021

APIC

View full text Add to dashboard Cite

Caudal anesthesia is commonly used a regional anesthesia technique for sub-umbilical surgeries in pediatrics and for chronic pain management in adults. Ultrasound guided caudal epidural block improves the success rate with minimizes complications. We report a patient who underwent lateral sphincterotomy under ultrasound guided caudal epidural anesthesia and developed transient urinary incontinence with prolonged perineal sensory loss postoperatively. Key words: Anesthesia, Caudal epidural, Ultrasound. Citation: Preethipriyadharshini R, Vadhanan CP, Bokka N. Transient bladder incontinence following ultrasound guided caudal epidural block. Anaesth. pain intensive care 2021;25(1):102–104; DOI: 10.35975/apic.v25i1.1437 Received: 17 October 2020; Reviewed: 4 November 2020; Accepted: 5 December 2020

show abstract

“…The results of their study showed that addition of 1μg.kg -1 of clonidine to intrathecal bupivacaine is safe and likely to be as effective as higher dosages minimizing the side effects [6] . Negri et al, 1997, looked at the interactions and effects on the cardiovascular system of spinal anaesthesia with clonidine and bupivacaine in young humans and found the addition of 105 μg clonidine to hyperbaric bupivacaine 1% was particularly useful in unilateral spinal anaesthesia, exerting minimal influence on haemodynamic parameters and guarantying a satisfactory postoperative analgesia [7] . Chiari et al, 1998, in a dose response study using intrathecal clonidine as sole analgesic during first stage of labour found that 50-200μg of intrathecal clonidine produces dose dependent analgesia.…”

Section: Discussionmentioning

confidence: 99%

Intrathecal bupivacaine (0.5%) with clonidine (1µg/kg) versus intrathecal bupivacaine (0.5%) with fentanyl (25 µg): Effects on Hemodynamic changes

Dhummansure,

Inamdar

2020

Int. J. Med. Anesthesiology

View full text Add to dashboard Cite

Bupivacaine controls pain at the axonal level by interfering with the nerve membrane. It physically blocks the sodium channel by reversibly binding to receptors on the intracellular side of the membrane. While the sodium channel is inactive, an action potential cannot form and nerve impulse conduction cannot be sent across the nerve membrane and to the brain. The result of this is a loss of feeling or numbness when the drug is given. This clinical study was conducted on 60 adult patients of ASA physical status 1 & 2 in the age group of 18 years to 60 years, of either sex, posted for elective lower limb, lower abdominal, gynaecological and urological surgeries under spinal anesthesia. The changes in diastolic blood pressure at 30 min and 60 min were statistically significant p<0.05 (here it is p=0.016 and p=0.001). There were not much differences in the diastolic blood pressure observed upto 180 minutes after the administration of the drugs except at 30 and 60 min. Majority of patients in clonidine group had significant sedation, p<0.05(here it is p=0.01) compared to fentanyl group.

show abstract

Cauda equina syndrome following an uneventful spinal anaesthesia

Cited by 12 publications

References 4 publications

Intrathecal midazolam is a comparable alternative to fentanyl and nalbuphine as adjuvant to bupivacaine in spinal anesthesia for elective Cesarean Section; a randomized controlled double-blind trial

Intrathecal midazolam is a comparable alternative to fentanyl and nalbuphine as adjuvant to bupivacaine in spinal anesthesia for elective Cesarean Section; a randomized controlled double-blind trial

Transient bladder incontinence following ultrasound guided caudal epidural block

Intrathecal bupivacaine (0.5%) with clonidine (1µg/kg) versus intrathecal bupivacaine (0.5%) with fentanyl (25 µg): Effects on Hemodynamic changes

Contact Info

Product

Resources

About