Transient Ischaemic Attack After Spinal Anaesthesia

Chung, Raymond; Goodwin, Ashley

doi:10.1093/bja/67.5.635

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…The sequence of return of neurological activity following tetracaine subarachnoid block is sympathetic nervous system activity, pinprick sensation, somatic motor function followed by proprioception in the feet. Autonomic fibres are blocked first, followed by sensory loss to touch/pinprick, followed by loss of proprioception, and lastly motor loss [5]. The return will also be in the same order.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Long TNS following Caesarean Section under Spinal Anaesthesia

Kishanrao

2023

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The first regional anaesthetic technique performed was spinal anaesthesia, and the first operation under spinal anaesthesia was in 1898 in Germany by August Bier. Spinal anaesthesia (SPA) is in common use worldwide for surgical procedures involving the lower abdomen, pelvis, perineal and lower extremities. It is beneficial for procedures below the umbilicus. Currently more than 50% global surgical patients undergo spinal anaesthesia every year. It is estimated that in USA 50 million individual were given spinal anaesthesia in 2022 and in India 60% of surgeries were performed under RA in 2021 as per a recent survey. Benefits of Spinal anaesthesia include prompt recovery, early return of normal functions, low chances of a blood clot following surgery and has less incidence of sickness, vomiting, when compared to a general anaesthetic for similar procedure. While acknowledging the benefits of SPA, Anaesthetists should be aware of and must inform clients of common side effects like acute back pain after spinal injection, that resolves with simple measures, Nausea, vomiting, headache and hypotension and Low-frequency hearing loss. One of the rare complications called Transient Neurologic Symptoms (TNS) with symptoms of, exclusive pain in buttocks, thighs, legs, few hours to ~ 1 day, lasting up to 10 days. After initial pain patient may notice numbness usually in left buttock area and weakness in gluteal muscles involved, that may prolong for 6 months to a year. The incidence India is quoted as 10-12 cases per lakh spinal anaesthesia procedures mainly caesarean sections. This article is of one such case the author is managing since a month. A 26-year-old lady primigravida, underwent caesarean section for the delivery 2 months ago. She was more concerned about the premature baby’s feeding challenges, but coincidentally brought to author’s notice. She has been put on a few o lower limb and abdominal muscle strengthening exercises and supplemented Tablet Neurobion (vit B12) forte one tablet a day. As of 22 /08/23 she has improved muscle power (20%) able to sit up with the support of upper and Numbness has also improved a bit. Material & Methods: One rare case of TNS, clinical diagnosis, management, Physiotherapy, Literature review and case report studies.

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Section: Discussionmentioning

confidence: 99%

A Rare Case of Long TNS following Caesarean Section under Spinal Anaesthesia

Kishanrao

2023

COTC

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“…Hypotension decreases cerebral blood flow and, in a hypercoagulable state like pregnancy, may lead to a transient ischaemic attack, manifesting as voice change. [1] Absence seizures may cause transient dysphonia after SAB. Intrathecal administration of lipophilic opioids may cause dysphagia, facial numbness, and aphasia due to rapid rostral spread to the speech area or cranial nerves.…”

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confidence: 99%