Patient was taken immediately for MRI of cervical, thoracic, and lumbar spine and brain CT, which were negative for spinal hematoma and cord compression. While being in the recovery room, patient began complaining of symmetric, bilateral lower extremity weakness with subsequent paraplegia and upper extremity “heaviness,” with consequent sensory deficits to the C4-C5 levels. The hemiarthroplasty was converted to general endotracheal anesthesia and completed. Spinal anesthesia was attempted twice and it was realized that approximately 0.4 mg of digoxin had been accidentally injected into the intrathecal space. This is 52-year-old male with a complicated medical history significant for end-stage renal disease on hemodialysis three times a week, admitted for elective total hip hemiarthroplasty. Here we report on the case of a 52-year-old old male with multiple comorbidities who underwent accidental intrathecal digoxin administration during an elective surgery and its successful management. However, limited data exists on the effects and management of intrathecal digoxin administration.
Its effects range in severity and duration. The intrathecal administration of digoxin has been cited in the past. Introductionĭigoxin is a cardiac glycoside used as an inotrope in heart failure. Here, we report on the case of the successful management of accidental intrathecal digoxin administration in an elderly male with end-stage renal disease. However, there has been no case citing the effects of intrathecal digoxin in light of end-stage renal disease in the elderly. The systemic effects of digoxin toxicity have been well-known.
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