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Paraplegia following transurethral surgery
Canadian Anaesthetists' Society Journal
|July 1, 1976
Summary
Paraplegia occurred after spinal anesthesia for prostate surgery due to a T4 spinal lesion. Contributing factors may include lumbar puncture effects and intraoperative fluid overload impacting spinal cord cells.
Area of Science:
- Neurology
- Anesthesiology
- Oncology
Background:
- Spinal anesthesia is commonly used for transurethral prostatic resection.
- Complications, though rare, can significantly impact patient outcomes.
Observation:
- A case of paraplegia is presented following spinal anesthesia.
- The patient underwent a transurethral prostatic resection procedure.
Findings:
- Further investigation revealed a metastatic peridural compressive lesion at the T4 level.
- Potential contributing factors include lumbar puncture-induced perimedullary vascular engorgement and cerebrospinal fluid (CSF) dynamics alterations.
- Intraoperative water intoxication causing spinal cord cell swelling is also considered.
Implications:
- Highlights the importance of considering spinal pathology in anesthesia complications.
- Suggests potential mechanisms for neurological deficits post-spinal anesthesia.
- Emphasizes the need for thorough pre-operative assessment and vigilant intra-operative monitoring.