Korean J Anesthesiol.  1998 Oct;35(4):786-790. 10.4097/kjae.1998.35.4.786.

Cauda Equina Syndrome Following Epidural Anesthesia: A case report

• Han KD
• Jeong YJ
• Lim SA

• KMID: 2091287
• DOI: http://doi.org/10.4097/kjae.1998.35.4.786

Abstract

Severe neurologic complication after epidural anesthesia is very rare. We experinced a case of cauda equina syndrome following epidural anesthesia with 2% lidocaine 20 ml, alkalinized with sodium bicarbonate and 1: 200,000 epinephrine added in female patient underwent abdominal hysterectomy. She complained hypoesthesia of buttock, perineum, left leg and weakness of left leg. She also suffered from urinary retension and defecation difficulty and abdominal discomfort 2 days after epidural block. In MRI taken 4 days after block, spinal stenosis (L4-5) and mild disc bulging (L3-4) were noted. She was treated with medication, bladder training and physical therapy and recovered slowly but gradually, finally discharged 2 months after block with mild weakeness of left leg. We suggest the causative factors are the temporary neural compression due to spinal stenosis and the spinal cord ischemia due to vascular spasm because of added epinephrine.

Keyword

Anesthesia: epidural; Complication: cauda equina syndrome

MeSH Terms

Anesthesia, Epidural*
Buttocks
Cauda Equina*
Defecation
Epinephrine
Female
Humans
Hypesthesia
Hysterectomy
Leg
Lidocaine
Magnetic Resonance Imaging
Perineum
Polyradiculopathy*
Sodium Bicarbonate
Spasm
Spinal Cord Ischemia
Spinal Stenosis
Urinary Bladder
Epinephrine
Lidocaine
Sodium Bicarbonate