Anest. intenziv. Med. 2009;20(2):78-83

Anterior spinal artery syndrome as a complication of neuroaxial blocade - successful treatment with prostacyclin (case report)Anaesthesiology - Case Reports

Stibor Bronislav^1,*, Schwameis Franz¹, Fellner Hermann²

¹ Abteilung für Anästhesie und Intensivmedizin, Landesklinikum Baden, Baden bei Wien, Rakousko

² Röntgeninstitut, Landesklinikum Baden, Baden bei Wien, Rakousko

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

Received: October 9, 2008; Accepted: January 20, 2009; Published: April 1, 2009  Show citation