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Anesth Analg 2005;101:1847-1848
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000184126.57327.C3

REGIONAL ANESTHESIA

Persistent Cauda Equina Syndrome with No Identifiable Facilitating Condition After an Uneventful Single Spinal Administration of 0.5% Hyperbaric Bupivacaine

Thouraya Chabbouh, MD, Claude Lentschener, MD, Mathieu Zuber, MD, Nicole Jude, MD, Bernard Delaitre, MD, and Yves Ozier, MD

Université Paris-Descartes, Faculté de Médecine; Assistance Publique – Hôpitaux de Paris, Hôpital Cochin; Université Paris-Descartes, Faculté de Médecine; Hôpital Sainte Anne, Paris, France

Address correspondence to Claude Lentschener, MD, Department of Anesthesia and Critical Care, Hôpital Cochin, 27 rue du Faubourg Saint Jacques, 75679 Paris Cedex 14, France. Address e-mail to claude.lentschener{at}cch.ap-hop-paris.fr.

We diagnosed cauda equina syndrome 15 h after uneventful single spinal administration of 0.5% hyperbaric bupivacaine 12.5 mg through a 27-gauge pencil-point type needle. No preexisting neurologic disorder was recorded. There was no pain or paresthesia during needle placement or drug injection. The sensory levels were bilateral, symmetric, and caudal to T8. Resolution of most of the symptoms occurred within a few days but some foot drop persisted for 2 yr after the procedure. Bupivacaine neurotoxicity is suggested by the absence of any other identifiable cause for this neurologic deficit.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins and Stanford University Libraries' HighWire Press®. Copyright 2005 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2005 by the International Anesthesia Research Society.