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Stepwise Rostrocaudal Brainstem Anesthesia as a Complication of Local Anesthesia: A Case Report

Braden Waters1, Ryan R Kroll, John Muscedere

  • 1From the *Department of Critical Care Medicine, McMaster University, Hamilton, Ontario, Canada; †Department of Internal Medicine, ‡Department of Critical Care Medicine, §Department of Medicine, Division of Neurology, and Division of Respirology, and ‖Department of Anesthesiology and Perioperative Medicine, Kingston General Hospital, Queen's University, Kingston, Ontario, Canada.

A & a Case Reports
|July 11, 2017
PubMed

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While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
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Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
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Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
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