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Recently we have a case of cerebrospinal fluid-cutaneous fistula following spinal anesthesia used for indirect inguinal hernia repair. But we couldn't see any comment in the textbook about the management of cerebrospinal fluid fistula from inthratecal space to skin due to postdural puncture for purpose of spinal (intrathecal) anesthesia.
Cutaneous cerebrospinal fluid (CSF) fistula are known to occur rarely under spinal puncture during spinal anesthesia, and CSF leaks via that fistula. This complication is often self-limiting but sometimes needed some treatment procedures such as intravenous fluid restruction, patient prone position, strecth dressing of wound, epidural injection of autologous blood patche or fibrin glue, or uncommonly use of CSF drainage system.
We think that if this complication and its' management is included in new edition of the textbook it will be better.
With our regards,
Hakan Erbay, M.D. Assisstant Professor of Anesthesiology Pamukkale University, Medical Faculty Department of Anesthesiology and Intensive Care, Denizli, Turkey
Erkan Tomatir, M.D. Associated Professor of Anesthesiology Pamukkale University, Medical Faculty Department of Anesthesiology and Intensive Care, Denizli, Turkey
With our regards,
Hakan Erbay, M.D. Assisstant Professor of Anesthesiology Pamukkale University, Medical Faculty Department of Anesthesiology and Intensive Care, Denizli, Turkey
Erkan Tomatir, M.D. Associated Professor of Anesthesiology Pamukkale University, Medical Faculty Department of Anesthesiology and Intensive Care, Denizli, Turkey