Late complications of spinal anaesthesia - A prospective study of 5000 cases

Abraham, AA; Shetty, Riyan; Ninan, Manju

doi:10.4103/0970-9185.75104

Cited by 3 publications

(1 citation statement)

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“…13 Total spinal block has been reported to be as high as 2% 10 where as in few studies, this have been reported to be as low as 0.3% 16 or even nil. 17 This has been related to high level of sensory block produced. 7 Treatment requires cardio respiratory resuscitative measures and stabilization of the patient; head lift and jaw thrust to keep airway open, high flow oxygen to maintain oxygen saturation.…”

Section: Discussionmentioning

confidence: 99%

Severe life threatening cardiovascular complications following spinal anaesthesia: A case series

Pantha¹,

Basnet²,

Piya³

et al. 2011

jgpeman

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Spinal anaesthesia, one of the safe and commonly given regional anaesthesias throughout the world1 was introduced by Dr August Bier in 1899. It is faster, easier to perform and patients are more comfortable than with general anaesthesia. Patan Hospital is one of the tertiary care referral hospital where many surgeries are performed every year. Obstetric, orthopaedic and general surgical cases are done under spinal anaesthesia in this hospital. We present here, a series of two life threatening complications following spinal anaesthesia in our patients who had undergone surgery under spinal anaesthesia.

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Section: Discussionmentioning

confidence: 99%

Severe life threatening cardiovascular complications following spinal anaesthesia: A case series

Pantha¹,

Basnet²,

Piya³

et al. 2011

jgpeman

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The leptomeninges as a critical organ for normal CNS development and function: First patient and public involved systematic review of arachnoiditis (chronic meningitis)

Palackdkharry¹,

Wottrich²,

Dienes³

et al. 2022

PLoS ONE

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Background & importance This patient and public-involved systematic review originally focused on arachnoiditis, a supposedly rare “iatrogenic chronic meningitis” causing permanent neurologic damage and intractable pain. We sought to prove disease existence, causation, symptoms, and inform future directions. After 63 terms for the same pathology were found, the study was renamed Diseases of the Leptomeninges (DLMs). We present results that nullify traditional clinical thinking about DLMs, answer study questions, and create a unified path forward. Methods The prospective PRISMA protocol is published at Arcsology.org. We used four platforms, 10 sources, extraction software, and critical review with ≥2 researchers at each phase. All human sources to 12/6/2020 were eligible for qualitative synthesis utilizing R. Weekly updates since cutoff strengthen conclusions. Results Included were 887/14286 sources containing 12721 DLMs patients. Pathology involves the subarachnoid space (SAS) and pia. DLMs occurred in all countries as a contributor to the top 10 causes of disability-adjusted life years lost, with communicable diseases (CDs) predominating. In the USA, the ratio of CDs to iatrogenic causes is 2.4:1, contradicting arachnoiditis literature. Spinal fusion surgery comprised 54.7% of the iatrogenic category, with rhBMP-2 resulting in 2.4x more DLMs than no use (p<0.0001). Spinal injections and neuraxial anesthesia procedures cause 1.1%, and 0.2% permanent DLMs, respectively. Syringomyelia, hydrocephalus, and arachnoid cysts are complications caused by blocked CSF flow. CNS neuron death occurs due to insufficient arterial supply from compromised vasculature and nerves traversing the SAS. Contrast MRI is currently the diagnostic test of choice. Lack of radiologist recognition is problematic. Discussion & conclusion DLMs are common. The LM clinically functions as an organ with critical CNS-sustaining roles involving the SAS-pia structure, enclosed cells, lymphatics, and biologic pathways. Cases involve all specialties. Causes are numerous, symptoms predictable, and outcomes dependent on time to treatment and extent of residual SAS damage. An international disease classification and possible treatment trials are proposed.

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Severe life threatening cardiovascular complications following spinal anaesthesia: A case series

Pantha¹,

Basnet²,

Piya³

et al. 2011

jgpeman

View full text Add to dashboard Cite

show abstract

Late complications of spinal anaesthesia - A prospective study of 5000 cases

Cited by 3 publications

References 0 publications

Severe life threatening cardiovascular complications following spinal anaesthesia: A case series

Severe life threatening cardiovascular complications following spinal anaesthesia: A case series

The leptomeninges as a critical organ for normal CNS development and function: First patient and public involved systematic review of arachnoiditis (chronic meningitis)

Severe life threatening cardiovascular complications following spinal anaesthesia: A case series

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