Hoarseness after spinal anesthesia: a case report

Authors

  • S. P. Sharma Department of Anaesthesiology and Critical Care, Military Hospital, Jaipur, Rajasthan, India
  • Anuj Singh Department of Anaesthesiology and Critical Care, Govt Hospital, Joshimath, Uttarakhand, India
  • Awanish Karan Department of ENT and HNS, Govt Hospital, Joshimath, Uttarakhand, India
  • Ajay Kumar Department of Anaesthesiology and Critical care, Military Hospital Dehradun, Uttarakhand, India
  • D. B. S. Brashier Department of Pharmacology, Govt Hospital, Joshimath, Uttarakhand, India
  • Dimple Vishal Department of Anaesthesiology and Critical Care, Govt Hospital, Joshimath, Uttarakhand, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20203217

Keywords:

Spinal anaesthesia, Hoarseness, Pregnancy, Vocal cord palsy, Post dural puncture headache, Sub arachnoid block

Abstract

Hoarseness is a common entity encountered post intubation in cases operatively managed under general anaesthesia and during regional anaesthesia mainly in cervical/brachial plexus block as a consequence of involvement of phrenic nerve. Limited reports of hoarseness, associated with spinal anaesthesia (sub arachnoid block) in obstetric and gynecology cases have been documented by various authors. Here we document a case of hoarseness in 24-year-old parturient lasting for 10-14 days, after spinal anaesthesia with bupivacaine (H) for lower segment caesarean section. The hoarseness in this case can be due to unilateral vocal cord palsy as a consequence of high-level sympathetic blockade by administration of sub arachnoid block or vagal neuropathy due to intracranial hypotension, as a consequence of spinal fluid egress from dural puncture site. However, in our case no evidence of post dural puncture headache (PDPH) due to egress of cerebrospinal fluid from puncture site was noted, interestingly pointing towards lower pressure change threshold for occurrence of vagal nerve and vocal cord palsy viz PDPH.

Author Biographies

S. P. Sharma, Department of Anaesthesiology and Critical Care, Military Hospital, Jaipur, Rajasthan, India

Consultant

Dept Of Anaesthesiology

Anuj Singh, Department of Anaesthesiology and Critical Care, Govt Hospital, Joshimath, Uttarakhand, India

Head Of Dept

Anaesthesiology and critical care

Awanish Karan, Department of ENT and HNS, Govt Hospital, Joshimath, Uttarakhand, India

Head 

Dept of ENT and H&N surgery

Ajay Kumar, Department of Anaesthesiology and Critical care, Military Hospital Dehradun, Uttarakhand, India

Head 

Dept of Anaesthesiology and critical Care

D. B. S. Brashier, Department of Pharmacology, Govt Hospital, Joshimath, Uttarakhand, India

Head

Dept of Pharmacological sciences

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Published

2020-07-22

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Section

Case Reports