Caudal block complication in a patient with trisomy 13.
In this report we describe a complication of a caudal block in a 4-year-old child with trisomy 13. The patient's history was remarkable for microcephaly, developmental delay, seizures, apnea, and prolonged emergence times. Induction of anesthesia and tracheal intubation were uneventful. A caudal block was aborted after positive aspiration of cerebrospinal fluid. A radiogram suggestive of spinal dysraphism, found on subsequent review, was confirmed by a magnetic resonance imaging scan consistent with tethered cord and dural ectasia. Congenital abnormalities associated with trisomy 13 and cutaneous signs suggestive of spinal abnormalities are reviewed. Avoidance of neuraxial regional anesthesia in these patients is recommended.
Cohen
Ira Todd
IT
Department of Anesthesiology, Children's National Medical Center, Washington, DC, USA. icohen@cnmc.org
D000015:Abnormalities, Multiple / Q000134:cerebrospinal fluid; D000763:Anesthesia, Caudal / Q000009:adverse effects* / Q000379:methods; D002675:Child, Preschool; D002882:Chromosomes, Human, Pair 13; D004108:Dilatation, Pathologic / Q000134:cerebrospinal fluid / Q000150:complications / Q000175:diagnosis; D004388:Dura Mater / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D009407:Nerve Block / Q000009:adverse effects* / Q000379:methods; D009436:Neural Tube Defects / Q000134:cerebrospinal fluid / Q000150:complications* / Q000175:diagnosis; D011859:Radiography; D035583:Rare Diseases; D016135:Spinal Dysraphism / Q000134:cerebrospinal fluid / Q000150:complications* / Q000175:diagnosis; D013131:Spine / Q000000981:diagnostic imaging / Q000473:pathology; D014314:Trisomy