Post-procedure adhesive arachnoiditis following obstetric spinal anaesthesia

Chattopadhyay, Ipsita; Jha, Amarendra Kumar; Banerjee, Sagarika; Basu, Srabani

doi:10.4103/0019-5049.181619

Cited by 7 publications

(6 citation statements)

References 3 publications

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“…Bowel and urinary manifestations including neurogenic bowel and bladder [ 2 ], constipation [ 3 ], urinary sphincter dysfunction [ 1 ] leading to urinary retention or incontinence, and urinary urgency [ 3 , 10 , 24 ] are often present in the late course of the disease [ 2 ]. Moreover, other findings such as headache [ 29 ], vertigo [ 29 ], sexual dysfunction [ 2 ], anorexia [ 1 ], cryptogenic skin rash, and itching [ 8 ] can also be seen.…”

Section: Reviewmentioning

confidence: 99%

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Spinal Adhesive Arachnoiditis: A Literature Review

Maillard¹,

Batista²,

Medeiros³

et al. 2023

Cureus

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Adhesive arachnoiditis (AA) is a rare inflammatory and scar-forming disease with several etiologies that may lead to incapacitating sequelae if not managed early. Nevertheless, as the onset of symptoms varies from days to years, the etiology is not often discovered. The disease is characterized by adhesions disrupting the cerebrospinal fluid flow and causing encapsulation and atrophy of the nerve root. Therefore, a range of clinical features may be present, including urinary, gastroenterology, dermatologic, and neurologic. In terms of diagnosis, magnetic resonance imaging is the gold standard showing pseudocysts with adherent and narrow nerve roots toward the center of the dural sac or peripherally cluster and narrow nerve roots with empty thecal sac. Despite its sensitivity and specificity, the imaging findings are not often associated with clinical manifestations, requiring treatment being based on anamneses and clinical findings. Nowadays, AA can be managed with pharmacological and non-pharmacological treatment, although none provides a completely satisfying result.

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Section: Reviewmentioning

confidence: 99%

“…Adhesive arachnoiditis (AA) is a debilitating condition characterized by persistent arachnoid inflammation leading to intrathecal scars and dural adhesions [ 1 - 3 ]. Although being considered a rare disease, the exact incidence is unknown and probably underestimated due to the omission of subclinical cases [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Spinal Adhesive Arachnoiditis: A Literature Review

Maillard¹,

Batista²,

Medeiros³

et al. 2023

Cureus

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“…Dexmedetomidine has highly specific alpha 2adrenergic receptor-agonist properties, with strong impacts on the central nervous system without respiratory depression. Dexmedetomidine has sedative, analgesic, sympatholytic, anesthetic-sparing and hemodynamic-stabilizing properties [8].…”

Section: Differentmentioning

confidence: 99%

Effect of Intrathecal Dexmedetomidine in Preventing Intra-operative Shivering after Spinal Anesthesia

Ibrahim

Elashry

Rahman

et al. 2021

JAMMR

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Background: Dexmedetomidine (DEX) has sedative, analgesic, sympatholytic, anesthetic-sparing and hemodynamic-stabilizing properties. This study aims to evaluate the effects of intrathecal DEX as an adjuvant to hyperbaric bupivacaine in the prevention of shivering in patients who underwent surgeries under Intrathecal anesthesia. Methods: A prospective double-blind, controlled, randomized study was conducted on 100 patients aged above 21 years old, ASA I & II undergoing lower limb orthopedic surgeries under intrathecal anesthesia. Patients were subdivided randomly into 2 equal group; Group Bupivacaine-Dexmedetomidine (BD): 5 µg dexmedetomidine diluted in 0.5 ml 0.9% normal saline was added to 12.5 mg heavy bupivacaine 0.5% and Group Bupivacaine (B): 0.5 ml 0.9% normal saline was added to 12.5mg heavy bupivacaine 0.5% (3ml volume). Results: Shivering occurred in 9 patients (18%) in group BD and 23 patients (46%) in group B with a significant decrease in group BD compared to group B (P = 0.003). The relative risk of developing shivering was decreased 53% (95% Confidence Interval: 74 – 16%) with group BD compared to group B. Tsai and Chu score was significantly better in group BD (P = 0.013). Conclusion: The use of intrathecal DEX (5μg) in conjugation with heavy bupivacaine help decrease the incidence and intensity of shivering when compared with heavy bupivacaine alone in surgeries under spinal anesthesia.

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“…However, this safe technique can still become unsafe and result in unanticipated morbidity and at times, mortality. Published in this issue of IJA are reports of complications attributed to CNBs, ranging from post-dural puncture headache (PDPH) to pneumocephalus, arachnoiditis, epidural haematoma, rectal perforation and aphonia[ 2 3 4 5 6 7 ] clearly indicating their occurrence, despite the professed improvements in the field. This reinforces the need for adopting meticulous measures while performing these simple procedures.…”

mentioning

confidence: 99%

“…The six reports[ 2 3 4 5 6 7 ] published in this issue highlight the various possible complications that can follow the ‘simple’ procedure of spinal anaesthesia. Hence, it is prudent that every anaesthesiologist adheres to strict protocols, follows the guidelines, incorporates aseptic principles, follows-up the patients in the post-operative period, detects the complications early and treats them aggressively and appropriately.…”

mentioning

confidence: 99%

Central neuraxial blocks: Complacency begets complications

Balavenkatasubramanian

2016

Indian J Anaesth

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Post-procedure adhesive arachnoiditis following obstetric spinal anaesthesia

Cited by 7 publications

References 3 publications

Spinal Adhesive Arachnoiditis: A Literature Review

Spinal Adhesive Arachnoiditis: A Literature Review

Effect of Intrathecal Dexmedetomidine in Preventing Intra-operative Shivering after Spinal Anesthesia

Central neuraxial blocks: Complacency begets complications

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