JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (4) Citing Articles via Google Scholar Google Scholar Articles by Tsui, B. C. H. Articles by Aronyk, K. Search for Related Content PubMed PubMed Citation Articles by Tsui, B. C. H. Articles by Aronyk, K. Related Collections Regional Anesthesia Pain Pharmacology

---

PAIN MEDICINE

Reversal of an Unintentional Spinal Anesthetic by Cerebrospinal Lavage

Ban C. H. Tsui, MD MSc, FRCP(C)^*, Stephan Malherbe, MB ChB, MMed, FCA(SA)^*, John Koller, MD FRCP(C)^*, and Keith Aronyk, MD FRCS(C)

Departments of *Anesthesiology and Pain Medicine and Neurosurgery, University of Alberta, Edmonton, Alberta, Canada

Address correspondence and reprint requests to Ban C. H. Tsui, MD, MSc, FRCP(C), Department of Anesthesiology and Pain Medicine, University of Alberta Hospitals, 3B2.32 Walter Mackenzie Health Science Centre, 8440-112 St., Edmonton, Alberta, Canada T6G 2B7. Address e-mail to btsui{at}ualberta.ca

In this case report, we describe the use of cerebrospinal fluid lavage as a successful treatment of an inadvertent intrathecally placed epidural catheter in a 14-yr-old girl who underwent a combination of epidural anesthesia and general anesthesia for orthopedic surgery. In this case, a large amount of local anesthetic was injected (the total possible intrathecal injection was 200 mg of lidocaine and 61 mg of bupivacaine), resulting in apnea and fixed dilated pupils in the patient at the end of surgery. Twenty milliliters of cerebrospinal fluid was replaced with 10 mL of normal saline and 10 mL of lactated Ringer’s solution from the "epidural" catheter. Spontaneous respiration returned 5 min later, and the patient was tracheally extubated after 30 min. No signs of neurological deficit or postdural puncture headache were noted after surgery.

IMPLICATIONS: Cerebrospinal lavage may be a helpful adjunct to the conventional supportive management of patients in the event of an inadvertent total spinal.

This article has been cited by other articles:

				H. Liu Cerebrospinal Lavage Seems to Be Safe and Effective in the Reversal of Inadvertent Spinal Anesthetic Injection Anesth. Analg., April 1, 2005; 100(4): 1215 - 1215. [Full Text] [PDF]

				B. Singh, C. Papneja, V. Datt, B. C. H. Tsui, and S. Malherbe Reversal of an Unintentional Spinal Anesthetic by Cerebrospinal Lavage * Response Anesth. Analg., January 1, 2005; 100(1): 296 - 297. [Full Text] [PDF]

				T. Schricker and B. C. H. Tsui Postoperative Intrathecal Morphine for Analgesia after Major Orthopedic Surgery? * Response Anesth. Analg., July 1, 2004; 99(1): 306 - 306. [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999