Long-term neurological complication following traumatic damage to the spinal cord with a 25 gauge whitacre spinal needle.

Neurological complications following regional anaesthesia may arise due to compression of the spinal cord or nerve roots secondary to haematoma or abscess, trauma, neurotoxicity or ischaemia. We report a patient who developed prolonged left lower limb paresis following combined spinal epidural (CSE) anaesthesia for emergency caesarean section. Magnetic resonance imaging (MRI) showed marked swelling of the lower end of the spinal cord suggesting traumatic damage of the cord by the spinal needle.

Pre-operative fasting and administration of regular medications in adult patients presenting for elective surgery. Has the new evidence changed practice?

Several studies have demonstrated that pre-operative fasting may be as short as 2 h for clear fluids and 6 h for solids with no adverse effect on volume or pH of gastric contents. Other studies suggest that many patients do not receive pre-operative prescribed medications. One hundred and fifty-three adults presenting for elective surgery (mean age 51 years) were studied to assess fasting practice.