Cauda Equina Syndrome and Spinal and Epidural Anesthesia.The Influence of Local Anesthetic, Needle Type and Position ofPuncture

Abstract

Background and Objectives: Severe complications such as Cauda Equina Syndrome (CES) lead to temporary or permanent disability have been ascribed to central neuraxial blocks. Some case reports, and very few retrospective studies, have focused their attention on the fact that central nerve blocks can cause, albeit rarely, permanent damage to the spinal cord or nerve roots, or both. This study is the experience of 48 years with spinal anesthesia and several publications and no definite neurological complications. This study is not a review of the subject. The primary objective of this study was to analyze the characteristics in relation to needles, puncture position, types of anesthetics, and baricity of local anesthetics.

Methods: This study on CES mainly on neuroaxial anesthesia complications was performed after searching using the key search words stated, using the Title, Abstract and Subject in six search sites (Pubmed, Science, Scielo, Lilacs, Medline, and Google Academic).

Results: The 12 phrases used for the survey found different responses depending on the site used. Several articles were studied, mainly correlated with neuraxial anesthesia.

Conclusions: The understanding of triggering factors of spinal anesthesia-induced cauda equina syndrome may prevent injuries and help early diagnosis and treatment, therefore changing patients prognosis. CES occurred with all anesthetics used in neuraxial blockade. The neurotoxicity of intrathecally administered of local anesthetic is increased by the addition of epinephrine, and is not influenced by the addition of glucose, puncture position, and type of needles. CES was not found with hypobaric anesthetic.