Authors: Stibor Bronislav 1; Schwameis Franz 1; Fellner Hermann 2 Authors‘ workplace: Abteilung für Anästhesie und Intensivmedizin, Landesklinikum Baden, Baden bei Wien, Rakousko 1; Röntgeninstitut, Landesklinikum Baden, Baden bei Wien, Rakousko 2 Published in: Anest. intenziv. Med., 20, 2009, č. 2, s. 78-83 Category: Anaesthesiology - Case Report
The authors report anterior spinal artery syndrome occurring as a complication of neuraxial blocade. They describe the cause and origin of the syndrome, the clinical symptoms, illness trajectory and its successful treatment. The patient, a 66-year-old man, underwent colon resection of a colonoscopically detected carcinoma. The surgery was carried out under general anaesthesia. An epidural catheter at the L2/3 level was placed preoperatively for peri - and postoperative analgesia. The patient was extubated about 8 hours after catheter placement. Later on, total spinal paraplegia was detected corresponding to the level of the catheter placement. The 3D-CT examination excluded an expansive process in the spinal canal area. Treatment with continuously administered epoprostenol was commenced. Epoprostenol is a prostacyclin with powerful anti-aggregating and vasodilator effects. Neurological symptoms totally disappeared within 9 hours of the beginning of epoprostenol administration and restitutio ad integrum was observed.
Keywords: anterior spinal artery syndrome – neuraxial blocade – epidural catheter – prostacyclin
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