Related Experiment Video
Updated: Jun 22, 2026

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
Published on: January 31, 2025
[Meningitis after combined spinal-epidural analgesia for labor: case report]
Carlos Escobar Vásquez1, Raquel da Rocha Pereira, Tomio Tomita
1ME(1) do CET/SBA - SAJ.
Background And Objectives:
Meningitis is a serious complication, although rare in regional anesthesia. This report aimed at presenting a case which evolved to meningitis after combined labor spinal-epidural analgesia.
Case Report:
Laboring patient, 25 years old, second gestation and previous c-section. Combined labor spinal-epidural analgesia was induced with double-puncture. Twenty-four hours later she presented with headache at rest, fever and mild chills, which regressed with symptomatic medication. Headache worsened in the 5th day. There were vomiting and neck pain in the 10th day. Symptoms became more severe in the 13th day. Lumbar puncture was performed. Clinical history and CSF analysis were compatible with bacterial meningitis.
Conclusions:
Combined labor spinal-epidural analgesia is very close to being the ideal technique. Care must be taken with the sterile technique to induce spinal blockade. The reported complication has occurred without an apparent technique failure and is inherent to techniques risk-benefit ratio.
Related Concept Videos
Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Bacterial Meningitis I: Introduction
Local Anesthetics: Clinical Application as Spinal Anesthesia
Viral Meningitis
Bacterial Meningitis
Brain Abscess l: Introduction
