Meningitis following a combined spinalepidural technique in a labouring term parturient

Abstract

Meningitis following a combined spinalepidural technique in a labouring term parturient

Pericardial placement of a pulmonary artery catheter

“…However, this intuitive argument is not supported by any clinical series and there is very likely to be a publication bias as authors and editors might tend to publish complications of a recent rather than a well-known technique (epidural or spinal). The present case has many clinical features in common with those reported by Cascio et al [5] and Aldebert et al [6]. In all these cases the anaesthetist wore a gown, a cap, a face mask and sterile gloves, symptoms appeared early and diagnosis was made within 24 h of the CSE.…”

“…Cascio et al [5] postulated that the Streptococcus salivarius isolated from their patient's CSF was a contaminant because it only grew in a single broth culture and also Anaesthesia, 1998, 53, 290-295 Case reports . ............................................................................................................................................................................................................................................... because it is not a bacterial pathogen that commonly causes meningitis.…”

“…Repeated attempts to advance the catheter may cause arrhythmias and knotting of the catheter so, in this case, repeated attempts at inserting the catheter were avoided. Arrhythmias reported during insertion include ventricular tachycardia, ventricular fibrillation, atrial arrhythmias and right bundle branch block [5]; these are usually self-limiting. Ventricular arrhythmias usually occur when the right ventricle is being traversed and commonly resolve once in the pulmonary artery [2].…”

Infection as a complication of neuraxial blockade

“…Nevertheless, judging by the numbers of published cases, it could be the second commonest neurological complication of neuraxial analgesia in labour, after paraesthesiae. Loo et al 6 found 20 cases, 31,[43][44][45][46][47][48][49][50][51][52][53][54] while at least seven others [55][56][57][58][59][60][61] and one case of Herpes simplex encephalitis 62 among parturients, and dozens more among non-obstetric patients, have been reported since.…”

Needle-through-needle compared to Eldor needle technique

“…However, since 1994 there have been two case reports of aseptic meningitis involving the needlethrough-needle technique [4,5]. Concerning both of these reports, we have commented on the possibility that these metallic microparticles should be considered in the differential diagnosis.…”