Síndrome de cauda equina posterior a la administración por vía subaracnoidea de bupivacaina hiperbárica al 0,75 %

Iván Morales; Alfredo Chirinos-Cuevas; Xavier Mantilla

Authors

Iván Morales
Alfredo Chirinos-Cuevas
Xavier Mantilla

Keywords:

bupivacaine, syndrome, cauda equina, pain, subarachnoid anesthesia.

Abstract

Cauda equina syndrome is a rare pathology in the area of anesthesiology. This is characterized by presenting a set of signs and symptoms that involve: pain, decrease or abolition of muscle strength, sphincter dysfunction and saddle hypoesthesia. The objective of this work is to present and discuss the clinical case of a patient with a diagnosis of cauda equina syndrome after the administration of hyperbaric 0.75% bupivacaine via the subarachnoid route. This is a 42-year-old female patient who underwent segmental cesarean section and bilateral salpingectomy with subarachnoid anesthetic block; and who subsequently at sixteen hours postoperatively presented: decreased muscle strength, lower limbs and hypoesthesia of the saddle region, knee jerk reflex: bilateral 0/4 and urinary retention. Pharmacological and physical treatment was started immediately, the diagnosis of cauda equina syndrome was established. The patient was discharged on postoperative day 10, with a significant decrease in the symptoms described above, later evidence of urinary retention, requiring intermittent bladder catheterization. Once the diagnosis was established, pharmacological and physiatric treatment was immediately installed to give a timely resolution of the pathology.

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