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Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

Published on: November 8, 2024

A case report of reappearance of spinal anesthesia

Alexander M Deleon¹, Honorio T Benzon, Theodore S Eisenman

¹Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. alexdeleon74@hotmail.com

Regional Anesthesia and Pain Medicine

|April 25, 2008

Abstract

Objective:

We present a case of reappearance of spinal anesthesia despite the use of plain (isobaric) lidocaine and without an associated cough or Valsalva maneuver.

Case Report:

A 66-year-old man had spinal anesthesia for knee arthroscopy. Two hours after the induction of spinal anesthesia and after the patient's motor strength had returned to the lower extremities, his head was elevated to 30 degrees. His legs became weak and he became hypotensive. Within 1 hour, his strength returned and he was discharged uneventfully.

Conclusions:

The reappearance of spinal anesthesia may be secondary to remixing of the cerebrospinal fluid with the pooled local anesthetic or transfer of the local anesthetic from the subdural to the subarachnoid space with movement of the patient.

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