AI Article Synopsis
- Cauda Equina Syndrome (CES) is a rare but serious condition that can occur after Combined Spinal-Epidural Anesthesia (CSEA), often requiring surgery to relieve compression on the spinal cord.
- A 34-year-old male developed CES symptoms like urinary retention and lower limb dysfunction after a procedure under CSEA, later found to have a Tarlov cyst contributing to his condition.
- The case highlights the need for awareness of CES in patients undergoing CSEA, especially regarding factors like drug neurotoxicity and anatomical abnormalities, and emphasizes the potential benefits of improved ultrasound-guided techniques.
Article Abstract
Background: Cauda Equina Syndrome (CES) after Combined Spinal-Epidural Anesthesia (CSEA) is a rare disease that most of the time need surgery to relieve spinal cord compression.
Case Presentation: A 34-year-old male patient underwent a procedure for prolapse and hemorrhoids (PPH) under CSEA. Anesthesia and surgery were uneventful. However, the patient gradually experienced urinary retention, lower abdomen and back pain, changes in bowel habits and neurological dysfunction of the lower limbs when the catheter was removed. It was later determined that the patient had Tarlov cyst at the left S1 level in the sacral canal. Finally, the patient completely recovered 20 days after drug conservative therapy onset.
Conclusion: This case suggests that CES might occur even after ordinary CSEA. The risk factors are drug neurotoxicity to ropivacaine and Tarlov cyst, which helped to accumulate ropivacaine. The development of ultrasound-guided CSEA and an ultrasound atlas of the spinal canal are required.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10617098 | PMC |
| http://dx.doi.org/10.1186/s12871-023-02311-w | DOI Listing |
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