Headache and seizures after cervical epidural injection in a patient undergoing coronary artery bypass grafting

• Main Authors: Dheeraj Arora, Yatin Mehta, Aashish Jain, Naresh Trehan
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2012-01-01
• Series: Annals of Cardiac Anaesthesia
• Subjects: Arterial blood pressure; Continuous noninvasive arterial pressure; Monitoring; Haloperidol; Intensive Care Unit; Midazolam; Post-open heart surgery agitation; Propofol; Sedation; Body mass index; Coronary bypass surgery; Obesity; Outcome; Atrial fibrillation; Cardiac surgery; Pro-brain natriuretic peptide; Cardiopulmonary bypass; Inotropes; Teamwork; Vasoplegic syndrome; Vasopressors; Ventricular dysfunction; Ventricular assist device; Congenital heart disease; Dexmedetomidine; Junctional ectopic tachycardia; Cardiac resynchronization therapy; Dilated cardiomyopathy; Epicardial pacing; Transesophageal echocardiography (TEE); Aberrant right subclavian artery; Complications; Transesophageal echocardiography; Abdominal aortic aneurysm; Endoaortic balloon occlusion; Abdominal aortic aneurysm repair; Intraoperative transesophageal echocardiography; Right coronary artery aneurysm; Tamponade; Coronary artery bypass grafting; Cervical epidural; Pneumocephalus
• Online Access: http://www.annals.in/article.asp?issn=0971-9784;year=2012;volume=15;issue=3;spage=244;epage=246;aulast=Arora

Epidural analgesia is widely used in cardiothoracic surgery. Most of the complications associated with epidural analgesia are related to the insertion techniques of epidural catheter. A 68-year-old obese patient posted for coronary artery bypass grafting surgery developed headache followed by seizures after insertion of the thoracic epidural catheter. Magnetic resonance imaging revealed air in the basal cisterns and in the left frontal region. The patient was managed conservatively and the symptoms subsided after 24 h. Later, the patient underwent coronary angioplasty.