Acute Myelitis After Correction of Hypospadias with Caudal Anesthesia

Jeniffer Almeida Correa do Nascimento; Matheus de Castro Abi-Ramia Chimelli; Jose Eduardo Smilgevicius Silva; Marcelo Grisolia Gonçalo; Pedro Paulo Vanzillota

doi:doi:10.11648/j.ijacm.20200801.16

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Acute Myelitis After Correction of Hypospadias with Caudal Anesthesia

Jeniffer Almeida Correa do Nascimento, Matheus de Castro Abi-Ramia Chimelli, Jose Eduardo Smilgevicius Silva, Marcelo Grisolia Gonçalo, Pedro Paulo Vanzillota

Received: 14 February 2020 Accepted: 4 March 2020 Published: 23 April 2020

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Abstract

Combined epidural anesthesia with general anesthesia is the preferred anesthetic technique for lower limb surgery as well as lower abdominal, genitourinary and perineal surgery in children. This case report below depicts a rare complication: acute myelitis. It occurred following surgical correction of hypospadias (first stage) under combined caudal epidural anesthesia with general anesthesia in an Eight-months-old infant, weighing 9.8 kilograms, with no surgical/anesthetic history, without known allergies, previously healthy, with adequate developmental milestones, physical examination without abnormalities, without difficult airway predictors, with adequate fasting time and normal laboratorial exams. Some etiologies for this case report have been suggested such as spinal cord trauma, infectious and vascular causes, local anesthetic and noxious chemicals neurotoxicity and demyelinating diseases. In spite of thorough scrutiny, we were not able to define a single cause for the clinical manifestations. In this setting, the treatment goal was to provide support measures and rehabilitation of neurological deficits.

DOI	10.11648/j.ijacm.20200801.16
Published in	International Journal of Anesthesia and Clinical Medicine (Volume 8, Issue 1, June 2020)
Page(s)	26-29
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Anesthesia, Acute Myelitis, Correction of Hypospadias, Neurological Deficits

References

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[2]	Beyaz, S. G., Tokgöz, O., & Tüfek, A. (2011). Caudal epidural block in children and infants: retrospective analysis of 2088 cases. Annals of Saudi medicine, 31 (5), 494-497.
[3]	Meyer, M. J., Krane, E. J., Goldschneider, K. R., & Klein, N. J. (2012). Neurological complications associated with epidural analgesia in children: a report of 4 cases of ambiguous etiologies. Anesthesia & Analgesia, 115 (6), 1365-1370.
[4]	Jöhr, M. (2015). Regional anaesthesia in neonates, infants and children: an educational review. European Journal of Anaesthesiology (EJA), 32 (5), 289-297.
[5]	Chen, Y., Yan, L., Zhang, Y., & Yang, X. (2019). The role of DRP1 in ropivacaine-induced mitochondrial dysfunction and neurotoxicity. Artificial cells, nanomedicine, and biotechnology, 47 (1), 1788-1796.
[6]	Desparmet, J. F. (1990). Total spinal anesthesia after caudal anesthesia in an infant. Anesthesia & Analgesia, 70 (6), 665-667.
[7]	Muckart, D. J., Bhagwanjee, S., & van der Merwe, R. (1997). Spinal cord injury as a result of endotracheal intubation in patients with undiagnosed cervical spine fractures. Anesthesiology: The Journal of the American Society of Anesthesiologists, 87 (2), 418-420.
[8]	Strafford, M. A., Wilder, R. T., & Berde, C. B. (1995). The risk of infection from epidural analgesia in children: a review of 1620 cases. Anesthesia & Analgesia, 80 (2), 234-238.
[9]	Martinez-Garcia, E., Pelaez, E., Roman, J. C., & Perez-Gallardo, A. (2005). Transverse myelitis following general and epidural anaesthesia in a paediatric patient. Anaesthesia, 60 (9), 921-923.
[10]	Jha S, Kumar R. Transverse myelitis following spinal anesthesia. Neurol India. 2006 Dec; 54 (4): 425-7.
[11]	Mukherjee D, Gautam S, Agarwal A, et al. Unexplained episode of sensory-motor deficit following lumbar epidural analgesia. Korean J Pain. 2019 Jan; 32 (1): 53-54.
[12]	Gunaydin B, Akcali D, Alkan M. Epidural anaesthesia for Caesarean section in a patient with Devic's Syndrome. Anaesthesia. 2001 Jun; 56 (6): 565-7.
[13]	Nishikawa T, Dohi S: Clinical evaluation of clonidine added to lidocaine solution for epidural anesthesia. ANESTHESIOLOGY 1990; 73: 853-9.
[14]	J. B. Dahl, L. Simonsen, T. Mogensen, J. H. Henriksen, and H. Kehlet, “The effect of 0.5% ropivacaine on epidural blood flow,” Acta Anaesthesiologica Scandinavica, vol. 34, no. 4, pp. 308–310, 1990.
[15]	Sviggum, H. P., Jacob, A. K., Arendt, K. W., Mauermann, M. L., Horlocker, T. T., & Hebl, J. R. (2012). Neurologic complications after chlorhexidine antisepsis for spinal anesthesia. Regional Anesthesia & Pain Medicine, 37 (2), 139-144.
[16]	Torsten E. Gordh, Stina Ekman & Anne-Sofie Lagerstedt (1984) Evaluation of Possible Spinal Neurotoxicity of Clonidine, Upsala Journal of Medical Sciences, 89: 3, 266-273.
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Jeniffer Almeida Correa do Nascimento, Matheus de Castro Abi-Ramia Chimelli, Jose Eduardo Smilgevicius Silva, Marcelo Grisolia Gonçalo, Pedro Paulo Vanzillota. (2020). Acute Myelitis After Correction of Hypospadias with Caudal Anesthesia. International Journal of Anesthesia and Clinical Medicine, 8(1), 26-29. https://doi.org/10.11648/j.ijacm.20200801.16

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Jeniffer Almeida Correa do Nascimento; Matheus de Castro Abi-Ramia Chimelli; Jose Eduardo Smilgevicius Silva; Marcelo Grisolia Gonçalo; Pedro Paulo Vanzillota. Acute Myelitis After Correction of Hypospadias with Caudal Anesthesia. Int. J. Anesth. Clin. Med. 2020, 8(1), 26-29. doi: 10.11648/j.ijacm.20200801.16

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AMA Style

Jeniffer Almeida Correa do Nascimento, Matheus de Castro Abi-Ramia Chimelli, Jose Eduardo Smilgevicius Silva, Marcelo Grisolia Gonçalo, Pedro Paulo Vanzillota. Acute Myelitis After Correction of Hypospadias with Caudal Anesthesia. Int J Anesth Clin Med. 2020;8(1):26-29. doi: 10.11648/j.ijacm.20200801.16

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@article{10.11648/j.ijacm.20200801.16,
  author = {Jeniffer Almeida Correa do Nascimento and Matheus de Castro Abi-Ramia Chimelli and Jose Eduardo Smilgevicius Silva and Marcelo Grisolia Gonçalo and Pedro Paulo Vanzillota},
  title = {Acute Myelitis After Correction of Hypospadias with Caudal Anesthesia},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {8},
  number = {1},
  pages = {26-29},
  doi = {10.11648/j.ijacm.20200801.16},
  url = {https://doi.org/10.11648/j.ijacm.20200801.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20200801.16},
  abstract = {Combined epidural anesthesia with general anesthesia is the preferred anesthetic technique for lower limb surgery as well as lower abdominal, genitourinary and perineal surgery in children. This case report below depicts a rare complication: acute myelitis. It occurred following surgical correction of hypospadias (first stage) under combined caudal epidural anesthesia with general anesthesia in an Eight-months-old infant, weighing 9.8 kilograms, with no surgical/anesthetic history, without known allergies, previously healthy, with adequate developmental milestones, physical examination without abnormalities, without difficult airway predictors, with adequate fasting time and normal laboratorial exams. Some etiologies for this case report have been suggested such as spinal cord trauma, infectious and vascular causes, local anesthetic and noxious chemicals neurotoxicity and demyelinating diseases. In spite of thorough scrutiny, we were not able to define a single cause for the clinical manifestations. In this setting, the treatment goal was to provide support measures and rehabilitation of neurological deficits.},
 year = {2020}
}

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TY  - JOUR
T1  - Acute Myelitis After Correction of Hypospadias with Caudal Anesthesia
AU  - Jeniffer Almeida Correa do Nascimento
AU  - Matheus de Castro Abi-Ramia Chimelli
AU  - Jose Eduardo Smilgevicius Silva
AU  - Marcelo Grisolia Gonçalo
AU  - Pedro Paulo Vanzillota
Y1  - 2020/04/23
PY  - 2020
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DO  - 10.11648/j.ijacm.20200801.16
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
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EP  - 29
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20200801.16
AB  - Combined epidural anesthesia with general anesthesia is the preferred anesthetic technique for lower limb surgery as well as lower abdominal, genitourinary and perineal surgery in children. This case report below depicts a rare complication: acute myelitis. It occurred following surgical correction of hypospadias (first stage) under combined caudal epidural anesthesia with general anesthesia in an Eight-months-old infant, weighing 9.8 kilograms, with no surgical/anesthetic history, without known allergies, previously healthy, with adequate developmental milestones, physical examination without abnormalities, without difficult airway predictors, with adequate fasting time and normal laboratorial exams. Some etiologies for this case report have been suggested such as spinal cord trauma, infectious and vascular causes, local anesthetic and noxious chemicals neurotoxicity and demyelinating diseases. In spite of thorough scrutiny, we were not able to define a single cause for the clinical manifestations. In this setting, the treatment goal was to provide support measures and rehabilitation of neurological deficits.
VL  - 8
IS  - 1
ER  -

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Author Information

Jeniffer Almeida Correa do Nascimento

Department of Anesthesiology, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
Matheus de Castro Abi-Ramia Chimelli

Department of Anesthesiology, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
Jose Eduardo Smilgevicius Silva

Department of Anesthesiology, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
Marcelo Grisolia Gonçalo
Pedro Paulo Vanzillota

Department of Anesthesiology, Hospital Municipal Jesus, Rio de Janeiro, Brazil

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APA Style

Jeniffer Almeida Correa do Nascimento, Matheus de Castro Abi-Ramia Chimelli, Jose Eduardo Smilgevicius Silva, Marcelo Grisolia Gonçalo, Pedro Paulo Vanzillota. (2020). Acute Myelitis After Correction of Hypospadias with Caudal Anesthesia. International Journal of Anesthesia and Clinical Medicine, 8(1), 26-29. https://doi.org/10.11648/j.ijacm.20200801.16

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ACS Style

Jeniffer Almeida Correa do Nascimento; Matheus de Castro Abi-Ramia Chimelli; Jose Eduardo Smilgevicius Silva; Marcelo Grisolia Gonçalo; Pedro Paulo Vanzillota. Acute Myelitis After Correction of Hypospadias with Caudal Anesthesia. Int. J. Anesth. Clin. Med. 2020, 8(1), 26-29. doi: 10.11648/j.ijacm.20200801.16

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AMA Style

Jeniffer Almeida Correa do Nascimento, Matheus de Castro Abi-Ramia Chimelli, Jose Eduardo Smilgevicius Silva, Marcelo Grisolia Gonçalo, Pedro Paulo Vanzillota. Acute Myelitis After Correction of Hypospadias with Caudal Anesthesia. Int J Anesth Clin Med. 2020;8(1):26-29. doi: 10.11648/j.ijacm.20200801.16

Copy | Download

@article{10.11648/j.ijacm.20200801.16,
  author = {Jeniffer Almeida Correa do Nascimento and Matheus de Castro Abi-Ramia Chimelli and Jose Eduardo Smilgevicius Silva and Marcelo Grisolia Gonçalo and Pedro Paulo Vanzillota},
  title = {Acute Myelitis After Correction of Hypospadias with Caudal Anesthesia},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {8},
  number = {1},
  pages = {26-29},
  doi = {10.11648/j.ijacm.20200801.16},
  url = {https://doi.org/10.11648/j.ijacm.20200801.16},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20200801.16},
  abstract = {Combined epidural anesthesia with general anesthesia is the preferred anesthetic technique for lower limb surgery as well as lower abdominal, genitourinary and perineal surgery in children. This case report below depicts a rare complication: acute myelitis. It occurred following surgical correction of hypospadias (first stage) under combined caudal epidural anesthesia with general anesthesia in an Eight-months-old infant, weighing 9.8 kilograms, with no surgical/anesthetic history, without known allergies, previously healthy, with adequate developmental milestones, physical examination without abnormalities, without difficult airway predictors, with adequate fasting time and normal laboratorial exams. Some etiologies for this case report have been suggested such as spinal cord trauma, infectious and vascular causes, local anesthetic and noxious chemicals neurotoxicity and demyelinating diseases. In spite of thorough scrutiny, we were not able to define a single cause for the clinical manifestations. In this setting, the treatment goal was to provide support measures and rehabilitation of neurological deficits.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - Acute Myelitis After Correction of Hypospadias with Caudal Anesthesia
AU  - Jeniffer Almeida Correa do Nascimento
AU  - Matheus de Castro Abi-Ramia Chimelli
AU  - Jose Eduardo Smilgevicius Silva
AU  - Marcelo Grisolia Gonçalo
AU  - Pedro Paulo Vanzillota
Y1  - 2020/04/23
PY  - 2020
N1  - https://doi.org/10.11648/j.ijacm.20200801.16
DO  - 10.11648/j.ijacm.20200801.16
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 26
EP  - 29
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20200801.16
AB  - Combined epidural anesthesia with general anesthesia is the preferred anesthetic technique for lower limb surgery as well as lower abdominal, genitourinary and perineal surgery in children. This case report below depicts a rare complication: acute myelitis. It occurred following surgical correction of hypospadias (first stage) under combined caudal epidural anesthesia with general anesthesia in an Eight-months-old infant, weighing 9.8 kilograms, with no surgical/anesthetic history, without known allergies, previously healthy, with adequate developmental milestones, physical examination without abnormalities, without difficult airway predictors, with adequate fasting time and normal laboratorial exams. Some etiologies for this case report have been suggested such as spinal cord trauma, infectious and vascular causes, local anesthetic and noxious chemicals neurotoxicity and demyelinating diseases. In spite of thorough scrutiny, we were not able to define a single cause for the clinical manifestations. In this setting, the treatment goal was to provide support measures and rehabilitation of neurological deficits.
VL  - 8
IS  - 1
ER  -

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