Reactions 1178 - 17 Nov 2007

SBupivacaine

Spinal subarachnoid haematoma followingintrathecal administration: case report

A 47-year-old woman developed a subacute spinalsubarachnoid haematoma following spinal anaesthesia withbupivacaine, prior to undergoing a sling operation for stressincontinence.

The woman, who had no history of bleeding tendency,received an intrathecal injection of 0.5% heavy bupivacaine2mL into the L4–L5 subarachnoid interspace. The operationlasted 60 minutes. Five days later she complained ofintermittent lower back pain, and bilateral pain in the glutealand thigh areas, leading to an uncomfortable gait. AT2-weighted MRI scan revealed a mass-like lesion in theintradural space, suspected to be a spinal subarachnoidhaematoma in the L4-S1 area.

The woman was treated with physical therapy andmedication, but the pain worsened. She underwent alaminectomy at L4 and L5. On opening the dural sac, there wasclotted blood between the cauda equina in the subarachnoidspace. The haematoma was removed from the dural sac,which was then sutured. Her bilateral sciatica improvedconsiderably postoperatively, and she continued to experienceonly minimal lower back pain.Park J-H, et al. Subacute spinal subarachnoid hematoma after spinal anesthesia thatcauses mild neurologic deterioration. Anesthesiology 107: 846-848, No. 5, Nov2007 - South Korea 801097505

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Reactions 17 Nov 2007 No. 11780114-9954/10/1178-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved