Subcutaneous cysts: another cause of "failed" spinal anesthesia?
Spinal anesthesia continues to be one of the major techniques in the arsenal of the modern anesthesiologist. Inadequate anesthesia may follow a spinal anesthetic for a variety of reasons. We report a case in which entry of a spinal needle into a subcutaneous cyst mimicked the free flow of cerebrospinal fluid seen with dural puncture. This was confirmed by microscopic examination of the fluid, which was consistent with the contents of a subcutaneous cyst. This represents an unusual cause for failure of spinal anesthesia. Such a possibility should be borne in mind, especially when "clear fluid" return occurs through a spinal needle placed at a relatively superficial depth.
Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06520-8051, USA.
D
D
Kelly
J A
JA
Gudin
S J
SJ
Brull
D000328:Adult; D000775:Anesthesia, Spinal; D002555:Cerebrospinal Fluid; D003560:Cysts / Q000503:physiopathology*; D005122:Exudates and Transudates / Q000737:chemistry; D006801:Humans; D007633:Keratins / Q000032:analysis; D008297:Male; D009339:Needles; D011677:Punctures; D012871:Skin Diseases / Q000503:physiopathology*
D007633:Keratins