Epidural and subdural hematoma following spinal anesthesia in infants rat model

Abstract

The aim of this study was to assess the epidural and subdural hematoma following spinal anesthesia in infants’ rat model. We investigated during 10, 15, and 20 days’ rats in group 1: intrathecal injection of bupivacaine 3.75 mg/kg (n = 7); group 2: received 37.5 μl midazolam 0.1% intrathecal with 37.5μl fentanyl 0.005% (no=7); injected into group 3 methylene blue 1 mg/ml (No. 7). Rats were exposed to spinal anesthesia in infancy and rotarod in motor function in adulthood. Histological evaluation and tissue extraction were also performed after the treatment and magnetic resonance imaging (MRI) of the head. MRI of the head of all rat pups that showed similar symptoms were performed. 4 rat pups showed the symptoms of hematoma Group1: small acute subdural hematoma at the left posterior temporal-parietal junction (PTPJ) and group 2 (one: right temporal epidural hematoma, two: Small acute subdural hematoma in the right temporomandibular area, and three: frontal-temporal-parietal-occipital hematoma). the rat pup that had epidural hematoma died 6 hours later. Finally, in the first group, one rat and the second group three rats showed hematoma symptoms. For these three rats, a histopathologic study was performed and indicate the presence of small acute subdural hematoma at the left posterior temporal-parietal junction, right temporal epidural hematoma, and frontal-temporal-parietal-occipital hematoma. In summary, because subdural or epidural hematoma of the skull can have serious consequences, differential diagnosis is very important for pain after spinal anesthesia.

Keywords

• Spinal anaesthesia
• subdural and epidural hematoma
• postdural puncture headache
• infant rats