MENINGITIS AFTER SUB ARACHNOID BLOCK :ITS NOT THAT UNCOMMON!!

Dr Anurag Garg

Abstract


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.


Keywords


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

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References


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