Foot drop after spinal anesthesia for cesarean section: a case report

Abstract

ObjectiveSpinal anesthesia is the preferred anesthetic technique for cesarean section. Neurological complications are very rare and often transient after spinal anesthesia.Case reportIn the present case, a 37-year-old woman was considered eligible for cesarean section due to fetal distress. She underwent spinal anesthesia with a 25-gauge pencil-point spinal needle. In the sitting position, 3 mL of 0.5% bupivacaine was injected following free flow of cerebrospinal fluid. The cesarean delivery was uneventful without severe and significant hemodynamic changes. After recovery, the patient complained of tingling and stiffness in the left leg, accompanied with movement disorders and foot drop. Lumbar magnetic resonance imaging was normal. After receiving 500 mg intravenous methylprednisolone daily for 72 hours, she was discharged from the hospital with no particular problems.ConclusionFoot drop is a neurological disorder, which occurs following natural childbirth and spinal anesthesia due to direct needle trauma or local anesthetic toxicity. This complication is transient and usually resolves within a few days. In our patient, the neurological complication appeared after labor and anesthesia recovery, which was treated by corticosteroids and anti-inflammatory drugs, with no particular side effects.

Small-Dose Ropivacaine Hydrochloride with Fentanyl versus Large-Dose of Ropivacaine Hydrochloride for Cesarean Section

“…In the past, cesarean section anesthesia was often treated with continuous peridural block anesthesia, but the effect was slow and the anesthetic effect was less than ideal. 1 With the continuous advancement of surgical techniques, the surgical incision has changed from the previous straight incision to the suprapubic transverse incision in cesarean section surgery, which greatly reduced the operation time, and the anesthesia program also changed. 2,3 Ropivacaine is a commonly used amide local anesthetic preparation, which has very light toxicity to the nervous system and heart, and does not affect the respiratory and circulatory systems of the parturients and the newborn babies.…”

Bilateral foot drop after spinal anesthesia for cesarean section

“…Spinal anesthesia is not without complications; however, neurological complications are extremely rare. One case of unilateral foot drop was reported following cesarean section in the literature which recovered fully with the conservative treatment, 4 but the bilateral foot drop following spinal anesthesia for cesarean section was not reported In the current case, the patient did not have any neurological or medical disorders before the cesarean section. The junior-most anesthetist was involved in giving anesthesia and pricked five times at different sites between L3 and L4 to achieve a free flow of spinal fluid.…”

“…Spinal anesthesia is not without complications; however, neurological complications are extremely rare. One case of unilateral foot drop was reported following cesarean section in the literature which recovered fully with the conservative treatment, 4 but the bilateral foot drop following spinal anesthesia for cesarean section was not reported…”

Foot Drop following Neuraxial Anaesthesia: A Case Report

“…Needle trauma and local anaesthetic toxicity following spinal anaesthetic arereported. 3,4 In a majority of patients it is difficult to pin point the exact aetiology. Cauda equina syndrome, spinal cord compression by epidural haematoma, epidural abscess and transient neurological symptoms are other causes of neurological damage.…”