Transient Voice Loss after Spinal Anaesthesia for Lower Limb Surgery: A Case Report

Abstract

Spinal Anaesthesia (SA) with hyperbaric bupivacaine and opioids is a preferred technique for lower limb surgeries in many centres. Among the various complications of such anaesthesia, postprocedural voice loss is relatively uncommon and has been reported very rarely in cases other than parturient patients. The sudden onset of such symptoms after anaesthesia and various other attributable causes may have implications for the subsequent surgery. The authors reported here a case of postprocedural voice loss in a 24-year old male patient prepared for open reduction and internal fixation surgery for a femur fracture. The patient developed immediate dysphonia along with tingling of the face and itching of the nasal alae after the administration of a subarachnoid block. The patient had a normal heart rate, blood pressure, and respiratory pattern. There was no history of any previous episode or possible attributable psychological condition. The authors carefully monitored the patient, assessed various causes of such a presentation, and noticed it to be transient and without any serious implications. They attributed the cause to the rostral spread of fentanyl, and the surgery was resumed. The authors concluded that immediate and transient voice loss after SA is an unexpected and unavoidable complication for lower limb surgery and may occur in non obstetric cases as well. However, if hypovolemia and respiratory abnormalities had been excluded, reassurance and close observation may be appropriate.