Title: Cauda equina syndrome and arachnoiditis from an epidural dose of chloroprocaine injected subdural: Farewell to a local anesthetic
Authors: J Antonio Aldrete, M.D., M.S,* Nora Godinez-Cubillo, MD,**Alfredo Ramirez-Bermejo,** Rhamsis F. Ghaly, MD***
"Currently, the generic form of CHLP contains Na bisulfite with the indication «For peripheral nerve block and infiltration»; the non-generic indicates «for caudal and epidural anesthesia
only» plus the clear warning «not for intrathecal anesthesia».
This cautious advice ignored that not uncommonly, incidental dural punctures occur and epidural catheters may migrate to
the subdural or to the subarachnoid spaces. By removing the bisulfite from CHLP, a false sense of security has resulted assuming that all presentations of this anesthetic could be used
inside of the vertebral canal, as long as it was kept extradural."
" We must ask ourselves, knowing what we know, should we continue
to inject an acid medication (pH 2.8 to 3.2) into the delicate
subarachnoid space, so patients may be discharged 12 minutes
why have there been no medical outcries about the rest of the poisons they can inject into our spines? that just ticked me off reading it to be honest. I mean with depomedrol there's a warning label on each vial "not for intrathecal use" ! I must be slow because I just don't get it.