Hoarseness after spinal anesthesia: a case report
Keywords:Spinal anaesthesia, Hoarseness, Pregnancy, Vocal cord palsy, Post dural puncture headache, Sub arachnoid block
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.
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