Dr Anurag Garg


Spinal Anaesthesia or Sub Arachnoid block is the commonest kind of anaesthesia given for surgeries below the umbilicus and lower limb surgeries. Meningitis should always be considered as a differential diagnosis in patients having post spinal headache, convulsions and changes in mental status.

The procedure is done following strict aseptic precautions. Despite taking all precautions there can still be a rare possibility of iatrogenic meningitis due to the spinal anesthesia. Sources of infection include contaminated spinal trays and medication, patient infection, and oral flora from anyone behind the patient without a facemask on. Povidone-iodine solution is most commonly chosen for skin antisepsis before initiation of epidural and spinal anesthesia. We report a case of chemical meningitis, which developed within few hours after subarachnoid block probably by hyperbaric bupivacaine, injected in the subarachnoid space. CSF pattern was suggestive of chemical meningitis. Patient recovered in 72 hours without any neurological sequelae.


Meningitis; asepsis; iatrogenic; bupivacaine; subarachnoid; cerebrospinal fluid

Full Text:



Yahya M, Srinivas C K, Thomas T. Aseptic meningitis following spinal anaesthesia- two case reports. Journal of Evolution of Medical and Dental Sciences 2013;17:2925-9.

Hashemi R, Okazi A. Iatrogenic meningitis after spinal anesthesia. Acta Medica Iranica 2008;46:434-6.

Phillips OC. Aseptic meningitis following spinal anesthesia. Anesth Analg 1970;49:867-71.

Bert AA, Laasberg LH. Aseptic meningitis following spinal anaesthesia- a complication of the past? Anesthesiology 1985;62(5):674-77

Videira RL, Neto PR, Neto MB. Post spinal meningitis and asepsis. Acta Anaesthesiol Scand 2002;46:639–46 Rege SA, Navarange S, Ravigopal N, Rohondia O. Complete flaccid paralysis following spinal anaesthesia – a case report. Indian J. Anaesth 2002;46:58-60.

Baer ET. Post–dural puncture bacterial meningitis. Anesthesiology 2006;105:381–93

Hebl J. The importance and implications of aseptic techniques during regional anesthesia. Reg Anesth Pain Med 2006;31:311-23.

Cascella C, Nausheen s, Cunha BA. A differential diagnosis of drug-induced aseptic meningitis. Infect Med 2008;25:331-4.

Tateno f, Sakakibara R, Kishi M, Ogawa E. Bupivacaine-induced chemical meningitis. J Neurol 2010;257:1327-9.

Besocke AG, Santamarina R, Romano LM, Femminini RA. Bupivacaine induced aseptic meningitis. Neurologia 2007;22(8):551-2.



  • There are currently no refbacks.