Neurologic complications following neuraxial anesthesia for cesarean delivery are rare. We present a 33-year-old parturient who developed prolonged lower extremity weakness following a single-shot subarachnoid block for cesarean delivery. After neurologic evaluation, she was diagnosed with bilateral sciatic neuropathies due to prolonged positioning for the anesthetic. We review the incidence of nerve injury associated with neuraxial anesthesia and risk factors for developing peripheral nerve injury in this context. We offer a solution to prevent this complication from occurring.
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http://dx.doi.org/10.1213/XAA.0000000000001026 | DOI Listing |
Acta Anaesthesiol Scand
March 2025
Department of Clinical Epidemiology and Biostatistics, Biostatistics Unit, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.
Background: Classic teaching is that spinal anesthesia is safe at or below the L2-L3 interspace. To evaluate this, we sought to determine the percentage of individuals with a conus medullaris termination (CMT) level at or below the L1-L2 interspace. Further, the relationship of CMT level to age, sex, body mass index (BMI), and spinal pathology was examined, as was the reliability of using Tuffier's line (TL) as an anatomical landmark.
View Article and Find Full Text PDFJ Neurosurg Anesthesiol
January 2025
Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia.
This focused review explores the current literature on anesthetic care of pregnant patients requiring intracranial intervention. Neuropathology in pregnancy is rare, and existing evidence for management remains limited by the ethical complexities surrounding maternal and fetal research-related risks; pregnant women are typically excluded from randomized controlled trials. Physiological changes during pregnancy, combined with additional fetal considerations, alter pharmacodynamics and complicate the safety profile of maternal interventions.
View Article and Find Full Text PDFJ Anesth Analg Crit Care
January 2025
Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", via Sergio Pansini 5, Naples, 80100, Italy.
Labor analgesia is increasingly widespread throughout the world with a rate ranging from 10 to 60%. The benefits regarding clinical and non-clinical maternal-fetal outcomes are currently discussed in international scientific literature. Even stage of labor needs a different and appropriate approach to control the pain; however, different techniques are reported in literature.
View Article and Find Full Text PDFIndian J Psychiatry
December 2024
Department of Psychiatry, Government Medical College and Hospital, Chandigarh, India.
Background: Postpartum depression (PPD) is a serious concern with multifactorial etiology. Association between prenatal anxiety, pain, and depression has been theorized.
Aim: In this randomized controlled trial, we studied the effect of pain relief by combined spinal epidural (CSE) and other factors influencing PPD.
Anaesth Crit Care Pain Med
January 2025
Department of Anesthesiology and Pain Medicine, Maisonneuve-Rosemont Hospital, Montréal, QC, Canada; Université de Montréal, Montréal, QC, Canada; Maisonneuve-Rosemont Hospital Research Center, Montreal, QC, Canada.
Background: Pharmacological sedation and analgesia are used to alleviate discomfort during awake medical procedures but can cause adverse effects like apnea and hypoxemia, increasing the need for airway management and prolonging recovery. Virtual reality (VR) has emerged as a non-pharmacological intervention to reduce the need for procedural sedatives and analgesics.
Methods: A systematic review and meta-analysis were conducted, assessing the impact of VR immersion on intraprocedural sedation and analgesia usage in adults (≥ 18 years).
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