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Revista Brasileira de Anestesiologia
On-line version ISSN 1806-907X
VASQUEZ, Carlos Escobar et al. Meningitis after combined spinal-epidural analgesia for labor: case report. Rev. Bras. Anestesiol. [online]. 2002, vol.52, n.3, pp. 330-334. ISSN 1806-907X. http://dx.doi.org/10.1590/S0034-70942002000300008.
BACKGRAUND AND OBJECTIVES: Meningitis is a serious complication, although rare in regional anesthesia. This report aimed at presenting a case which evolved to meningitis after combined labor spinal-epidural analgesia. CASE REPORT: Laboring patient, 25 years old, second gestation and previous c-section. Combined labor spinal-epidural analgesia was induced with double-puncture. Twenty-four hours later she presented with headache at rest, fever and mild chills, which regressed with symptomatic medication. Headache worsened in the 5th day. There were vomiting and neck pain in the 10th day. Symptoms became more severe in the 13th day. Lumbar puncture was performed. Clinical history and CSF analysis were compatible with bacterial meningitis. CONCLUSIONS: Combined labor spinal-epidural analgesia is very close to being the ideal technique. Care must be taken with the sterile technique to induce spinal blockade. The reported complication has occurred without an apparent technique failure and is inherent to techniques risk-benefit ratio.
Keywords : ANESTHETIC TECHNIQUES, Regional [combined spinal-epidural]; COMPLICATIONS [infection]; COMPLICATIONS [bacterial meningitis].