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In our case, as soon as, we had suspected neurological complication, we started the patient on a high dose of injection methylprednisolone 30/mg/kg over 30 min followed by continuous infusion at the rate of 5.4 mg/kg/h.In the meantime, during the discussion to shift the patient to higher center, we had found patient's power in both LL improved within an hour of starting infusion.The most likely causes in our case could be hematoma, trauma or neurotoxicity to nerves leading to CES.
A male patient aged 45 years was admitted to the Department of General Surgery with a complaint of acute abdomen, diagnosed as acute appendicitis and posted for an open appendectomy.
During preoperative examination thalassemia trait was elicited, he was evaluated previously in an institute after his son was diagnosed as thalassemia major.
Case of neurological complication following subarachnoid block in a patient with unsuspected coagulopathy.
Anesth Essays Res [serial online] 2017 [cited 2019 Sep 7];0-2. 2017/11/1/260/194563 Cauda equina syndrome (CES) as a complication of spinal anesthesia is characterized by varying degree of saddle anesthesia, sphincter dysfunction resulting in fecal incontinence, urinary retention, and paraplegia.
Neurological complications are rare following spinal anesthesia.
We are reporting neurological complication in a patient the following appendectomy under SAB with unsuspected coagulopathy.
Within the next 4 h, power in both LLs increased to 4/5.
As nearest higher referral center was 4 h drive, we managed patient conservatively in our hospital.
Arun Mathur Department of Anaesthesia and Critical Care, Kannur Medical College, Anjarakandy P.
O, Kannur - 670 612, Kerala India Source of Support: None, Conflict of Interest: None Subarachnoid block (SAB) is an extensively used regional anesthesia technique for many surgeries.