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2010, Number 4

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Rev Mex Anest 2010; 33 (4)

Cauda equina syndrome and arachnoiditis from an epidural dose of chloroprocaine injected subdural: Farewell to a local anesthetic

Aldrete JA, Godinez-Cubillo N, Ramirez-Bermejo A, Ghaly RF

Language: English
References: 46
Page: 220-224
PDF size: 377.84 Kb.


ABSTRACT

Chloroprocaine (CHLP) has undergone controversies related to its low pH, preservatives and antioxidants. In a recently delivered parturient scheduled to have a postpartum tubal ligation using the same catheter as for labor, aspiration was negative, The test dose with the anesthetic failed to indicate intrathecal or intravascular injection; delayed onset, led to further doses; after 15 mL had been given, arterial hypotension and sensory block was noted at T5, 10 mL more were given reaching a C5 level after a total dose of 25 mL had been completed. The slow onset suggested subdural injection; subsequently, the patient developed cauda equina and arachnoiditis suggesting that the dose intended for epidural anesthesia eventually entered the intrathecal space.


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