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Undesired intrathecal injections (UII) are rare but can cause serious neurological effects. Prompt cerebrospinal fluid (CSF) lavage and cardiopulmonary support are key treatments for inadvertent intrathecal administrations.

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Area of Science:

  • Medical Interventions
  • Anesthesiology
  • Neurology

Background:

  • The intrathecal space is crucial for medical interventions across various specialties.
  • Undesired/inadvertent intrathecal injections (UII) are infrequent but carry significant risks.
  • Existing literature primarily consists of isolated case reports and small case series.

Purpose of the Study:

  • To identify sources of UII.
  • To describe the clinical presentations of UII.
  • To outline appropriate management and prevention strategies for UII.

Main Methods:

  • Literature review and synthesis of existing case reports and series.
  • Classification of inadvertent injectants.
  • Analysis of clinical effects and treatment outcomes.

Main Results:

  • Inadvertent injectants include anesthetic agents, chemotherapeutics, contrast agents, antibiotics, corticosteroids, and tranexamic acid.
  • Clinical effects range from asymptomatic to severe neurological damage or death, depending on the agent and dose.
  • Cerebrospinal fluid (CSF) lavage and cardiopulmonary support are primary treatment modalities.

Conclusions:

  • UII require prompt and appropriate management, with CSF lavage potentially being lifesaving.
  • Comprehensive management and prevention strategies are essential to mitigate risks associated with UII.