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[Delayed respiratory arrest following spinal anesthesia].

T Klöss, K van Deyk, V Hempel

    Regional-Anaesthesie
    |July 1, 1984
    PubMed
    Summary
    This summary is machine-generated.

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    A rare complication of spinal anesthesia, characterized by slow anesthetic spread, aphonia, and respiratory insufficiency, occurred in a patient undergoing bladder carcinoma resection. Continuous anesthesiologic supervision is recommended for patients with uncertain spinal anesthesia spread.

    Area of Science:

    • Anesthesiology
    • Neurosurgery
    • Urology

    Background:

    • Transurethral resection of bladder carcinoma is a common urological procedure.
    • Spinal anesthesia with mepivacaine is frequently used for such procedures.
    • Potential complications, though rare, require careful monitoring.

    Observation:

    • A 71-year-old woman received spinal anesthesia with 4% hyperbaric mepivacaine for bladder carcinoma resection.
    • Despite proper positioning, the spinal anesthesia spread slowly cephalad.
    • Aphonia and respiratory insufficiency developed 60 minutes post-injection, necessitating intubation and ventilation.

    Findings:

    • The patient required intubation and mechanical ventilation for 4 hours due to delayed and excessive cephalad spread of spinal anesthesia.

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  • Full recovery from the spinal block was observed 6.5 hours after administration.
  • This case highlights a rare complication of spinal anesthesia, potentially linked to slow anesthetic spread.

    • Implications:

    • Continuous anesthesiologic supervision is crucial for patients receiving spinal anesthesia, especially when spread is unpredictable.
    • Understanding the etiology of such rare complications is vital for improving patient safety in urological surgery.
    • This case underscores the importance of vigilant monitoring during and after spinal anesthesia administration.