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Monoplegia after combined spinal epidural anesthesia
Onur Balaban1, Yavuz Gürkan, Alparslan Kuş
1Department of Anesthesiology and Reanimation, Kocaeli University Faculty of Medicine Hospital, Kocaeli, Turkey. obalaban75@hotmail.com.
Summary
A rare case of serious neurological complications, specifically right lower limb sensory loss and monoplegia, occurred after combined spinal epidural anesthesia (CSE). Prompt intervention and physical therapy led to partial recovery, highlighting potential risks of neuraxial anesthesia.
Area of Science:
- Anesthesiology
- Neurology
Background:
- Neuraxial anesthesia, including combined spinal epidural anesthesia (CSE), is commonly used for surgical procedures.
- Serious neurological complications are rare but can occur, necessitating careful patient monitoring and management.
Observation:
- A 36-year-old female developed profound neurological deficits (sensory loss and monoplegia) in her right lower limb 10 hours after CSE for venous stripping.
- Initial management included epidural catheter removal and MRI, which showed normal findings.
Findings:
- The patient experienced temporary but severe neurological deficits following CSE and patient-controlled epidural analgesia.
- Despite normal MRI results, the deficits suggested a possible radiculopathy or neurotoxicity potentially related to the anesthetic procedure or agents.
Implications:
- This case underscores the importance of vigilance for rare neurological complications after neuraxial blocks.
- Early recognition, intervention, and rehabilitation are crucial for managing such adverse events and improving patient outcomes.
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