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[Total spinal anesthesia after interscalenic plexus block].

D Frasca1, D Clevenot, A Jeanny

  • 1Service d'anesthésie et de réanimation chirurgicale, centre hospitalo-universitaire de Poitiers, rue de la Miletrie, BP 577, 86021 Poitiers cedex, France. denis.frasca@gmail.com

Annales Francaises D'Anesthesie Et De Reanimation
|October 16, 2007
PubMed
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Accidental spinal anesthesia occurred during an interscalene block due to catheter misplacement. This case highlights rare complications of regional anesthesia and emphasizes safety measures for shoulder surgery.

Area of Science:

  • Anesthesiology
  • Neurosurgery
  • Radiology

Background:

  • Interscalene block with catheter provides optimal analgesia for shoulder surgery.
  • This regional anesthesia technique is technically straightforward but carries risks of serious complications.

Observation:

  • A case of unintended spinal anesthesia is presented, resulting from accidental catheterization of the medullary canal during an interscalene block.
  • Tomodensitometry revealed myelographic changes due to non-ionic contrast media injection via the catheter during X-ray monitoring.

Findings:

  • Neurological signs associated with the complication resolved rapidly and without lasting effects.
  • The event underscores that even with safety precautions, locoregional anesthesia carries inherent risks.

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Implications:

  • Adherence to safety protocols, such as avoiding deep sedation and using short needles, is crucial for interscalene blocks.
  • Advanced techniques like ultrasound guidance and specialized catheters may reduce the incidence of such accidental dural punctures.