Revista Cubana de Anestesiología y Reanimación
versión On-line ISSN 1726-6718
CABANA SALAZAR, José Antonio; GARCIA CEBALLOS, Erlinda; GARCIA GARCIA, Gerardo y MELIS SUAREZ, Aneite. Cutaneous fistula of cerebrospinal fluid by peridural catheter. Rev cuba anestesiol reanim [online]. 2010, vol.9, n.3, pp. 218-222. ISSN 1726-6718.
The cerebrospinal fluid fistula after the insertion of a peridural catheter to treat the chronic pain in an Oncology patient is an uncommon complication. Objectives: To describe the perioperative behavior and the course of an Oncology patient presenting with chronic pain using a long-term peridural catheter for analgesia, as well as a cerebrospinal fluid fistula. Case presentation: A female patient aged 32 presenting with an advanced ovarian carcinoma; a peridural catheter was passed at L2-L3 level to administration of analgesia with local anesthetics and lyophilized morphine. At 28 days she had an abundant loss of fluid in the insertion site of catheter. She was studied by cytology corroborating the presence of cerebrospinal fluid and removing the catheter. The prescription was a significant reestablishment of fluid and aminophyline per os (a tablet every 8 hours). A compressing bandage was placed over the cutaneous orifice. At 24 hrs the fluid loss subsists being necessary a hematic patch. She had a satisfactory course. Conclusions: The cutaneous cerebrospinal fistulae are uncommon complications in the anesthesia practice; it is of multifactorial and imprecise origin with a pathophysiological basis and a therapeutical behavior still not well defined where the epidural patch with autologous blood seems a appropriate alternative.
Palabras llave : Cerebrospinal cutaneous fistulae; regional anesthesia complications; peridural catheter.