PROXIMAL PARAPARESIS FOLLOWING SPINAL-ANESTHESIA

A 70-year-old man with prostatic cancer extending to the urinary bladd er underwent transurethral resection of the bladder neck under spinal anesthesia and developed weakness of the proximal lower limbs a few ho urs after the procedure, The weakness persisted for several months, Be cause there were no local surgical complications (hematoma, infectious epiduritis, abscess) or bone metastases responsible for nerve root or spinal cord compression, a causal relation between the neurologic def icit and the spinal anesthesia was considered likely, Neurologic defic its are uncommon after spinal anesthesia and can be produced by compli cations of the surgical procedure (direct nerve injury, hematoma, absc ess), arachnoiditis, neurotoxicity of disinfectants or of preservative s added to solutions of anesthetic drugs, or spinal cord ischemia, Pre cipitating factors for spinal cord ischemia include faulty patient pos ition during the procedure, intraoperative arterial hypotension and in jection of vasoconstricting agents.