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PubMed1983

Meningitis--a complication of spinal anesthesia.

During a five-year period, 17 of 1429 patients admitted with meningitis had had recent spinal anesthesia in Cairo, Egypt. Ten of the 17 had positive cerebrospinal fluid cultures: 8 were Pseudomonas aeruginosa, 1 was Staphylococcus aureus, and 1 was Streptococcus mitis. These organisms were not cultured from patients who had not had spinal anesthesia. Two patients with negative cultures had lumbar spine x-ray changes consistent with tuberculosis. Antibiotic therapy was based upon the sensitivity of cultured organisms. Four of the 17 patients died. These data strongly suggest that meningitis in patients with recent spinal anesthesia is commonly due to unusual or nosocomial organisms. Aggressive, meticulous bacteriologic evaluation of these patients is essential.

Anesthesia, Spinal↗
PubMed1983

[Unremovable epidural catheter due to a sling and a knot. A rare complication of epidural anesthesia in obstetrics].

An epidural catheter inserted at the height of L2/3 could not be removed after spontaneous delivery of a healthy boy, manual extraction of the placenta and fixing the episiotomy. X-rays (lumbar spine a-p and lateral) were taken in order to visualize the epidural catheter's site. The catheter could only be recognized on the a-p but not on the lateral film. It was possible to recognize a foreign body in the ultrasonic study. The exact site of the catheter could not be determined. Continuous pulling in various positions (bend over, stretch and lateral position) could not remove the catheter. A consultant neurosurgeon tried also in vain to remove the fixed catheter. In a final trial pulling hard the catheter broke. The indication for operative extraction was given. Finally the catheter fixed in the ligamentum flavum building a loop and a tight knot in the epidural space could be freed up and removed surgically.

Adult↗