Subdural haematoma following infant spinal anaesthesia

S Bupivacaine/levobupivacaine Subdural haematoma: 2 case reportsIn a report, a 20-week-old boy and a male infant [age at reaction onset not clearly stated] developed subdural haematoma (SDH) following administration of levobupivacaine and bupivacaine, respectively [routes not stated].Case 1, the 6-week-old boy underwent bilateral inguinal hernia repair under spinal anaesthesia. The surgery was uneventful with 0.7 mL of 0.5 % levobupivacaine [lbupivacaine], which was administered via a 25-gauge needle on the first pass at the L4/5 level. At the age of 13 weeks, he showed an increase in head circumference to the 97 th centile. At the age of 20 weeks, his MRI scan showed bilateral frontal subdural collections. A non-accidental injury was suspected. Neurosurgical management was conservative as his development was appropriate and head circumference was stable. He remained well 2 years after the diagnosis.Case 2, the boy underwent bilateral inguinal hernia repair under spinal anaesthesia at the age of 7 weeks. The spinal anaesthetic was uneventful with 0.5 mL of 0.5% bupivacaine, which was administered via a 27-gauge needle on the first pass at the L4/5 level. Nine weeks after the surgery, he presented with abnormal eye movements. His subsequent MRI showed a small 5mm left-sided subdural collection. A non-accidental injury was suspected. He was conservatively managed. His both the abnormal eye movements and the subdural collections resolved. Two years after the diagnosis, he continued to develop normally.

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Rachianesthésie chez l’enfant : actualisation 2022

Veyckemans

2022

Anesthésie & Réanimation

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Subdural haematoma following infant spinal anaesthesia

Abstract: Paediatric health workers should be aware of the possibility of SDH after spinal anaesthesia and consider this as a differential diagnosis when investigating possible non-accidental injury in an infant.

Cited by 5 publications

References 10 publications

Abusive head trauma: neuroimaging mimics and diagnostic complexities

Abusive head trauma: neuroimaging mimics and diagnostic complexities

Bupivacaine/levobupivacaine

Rachianesthésie chez l’enfant : actualisation 2022

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