{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T01:05:46Z","timestamp":1776906346904,"version":"3.51.2"},"reference-count":8,"publisher":"Walter de Gruyter GmbH","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,10,25]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Cerebrospinal fluid cutaneous fistula is a rare but potentially serious complication of epidural analgesia. We report the case of a patient submitted to total knee arthroplasty under subarachnoid block and placement of lumbar epidural catheter for post-operative analgesia. The epidural catheter was found exteriorised on the fourth post-operative day, and the patient presented with a moderate fluid leak from the puncture site that was confirmed to be cerebrospinal fluid by cytological and chemical analysis. The initial therapeutic approach consisted of bed rest, hydration and prophylactic antibiotic therapy for 3 days, but it was ineffective as the leak persisted. A suture was placed at the epidural insertion site with immediate resolution of the leak. The suture was maintained for 5 days. The patient progressed satisfactorily without requiring further therapies.<\/jats:p>","DOI":"10.1515\/sjpain-2018-0073","type":"journal-article","created":{"date-parts":[[2018,6,22]],"date-time":"2018-06-22T18:16:40Z","timestamp":1529691400000},"page":"739-741","source":"Crossref","is-referenced-by-count":5,"title":["Cerebrospinal fluid cutaneous fistula after neuraxial anesthesia: an effective treatment approach"],"prefix":"10.1515","volume":"18","author":[{"given":"Ramiro","family":"Marinho","sequence":"first","affiliation":[{"name":"Department of Anesthesiology , Centro Hospitalar S. Jo\u00e3o, Largo do Prof. Abel Salazar 4099-001 , Porto , Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mara","family":"Sousa","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology , Centro Hospitalar S. Jo\u00e3o, Largo do Prof. Abel Salazar 4099-001 , Porto , Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filipa","family":"Machado","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology , Centro Hospitalar S. Jo\u00e3o, Largo do Prof. Abel Salazar 4099-001 , Porto , Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology , Centro Hospitalar S. Jo\u00e3o, Largo do Prof. Abel Salazar 4099-001 , Porto , Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu\u00edsa","family":"Guedes","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology , Centro Hospitalar S. Jo\u00e3o, Largo do Prof. Abel Salazar 4099-001 , Porto , Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2018,6,22]]},"reference":[{"key":"2025120910051626071_j_sjpain-2018-0073_ref_001","doi-asserted-by":"crossref","unstructured":"Dalal KS, Shiividya C. Cutaneous fluid leakage after epidural catheter removal. J Anesthesiol Clin Pharmacol 2015;31:133\u20134.","DOI":"10.4103\/0970-9185.150581"},{"key":"2025120910051626071_j_sjpain-2018-0073_ref_002","doi-asserted-by":"crossref","unstructured":"Abaza KT, Bogod DG. Cerebrospinal fluid-cutaneous fistula and pseudomonas meningitis complicating thoracic epidural analgesia. Br J Anaesth 2004;92:429\u201331.","DOI":"10.1093\/bja\/aeh069"},{"key":"2025120910051626071_j_sjpain-2018-0073_ref_003","doi-asserted-by":"crossref","unstructured":"Howes J, Lenz R. Cerebrospinal fluid cutaneous fistula: an unusual complication of epidural anaesthesia. Anaesthesia 1994;49:221\u20132.","DOI":"10.1111\/j.1365-2044.1994.tb03426.x"},{"key":"2025120910051626071_j_sjpain-2018-0073_ref_004","doi-asserted-by":"crossref","unstructured":"Juarez-Adame FM, Ruiz-Rubio Y, Zavalza-Gomez AB. Acetazolamide in the resolution of cerebrospinal fluid cutaneous fistula after peridural analgesia: case report. Cir Cir 2015;83:43\u20135.","DOI":"10.1016\/j.circen.2015.01.001"},{"key":"2025120910051626071_j_sjpain-2018-0073_ref_005","doi-asserted-by":"crossref","unstructured":"Tsai A, Ahmed S, Jingping S. Persistent cerebrospinal fluid cutaneous fistula after epidural analgesia: a case report and review of literature. J Anesthesiol Clin Sci 2014;3:2.","DOI":"10.7243\/2049-9752-3-2"},{"key":"2025120910051626071_j_sjpain-2018-0073_ref_006","unstructured":"Bakshi SG, Rana M, Doctor JR, Moiyadi AV, Qureshi S, Desai M. Persistent leak post epidural analgesia: diagnostic and therapeutic dilemma. Bombay Hosp J 2015;57:112\u20134."},{"key":"2025120910051626071_j_sjpain-2018-0073_ref_007","doi-asserted-by":"crossref","unstructured":"Thong SY, Goh SY. Cerebrospinal fluid cutaneous fistula after uneventful epidural analgesia. Global J Anesthesiology 2015;2:003\u20135.","DOI":"10.17352\/2455-3476.000007"},{"key":"2025120910051626071_j_sjpain-2018-0073_ref_008","doi-asserted-by":"crossref","unstructured":"Safa-Tisseront V, Thormann F, Malassin\u00e9 P. Effectiveness of epidural blood patch in the management of post-dural puncture headache. Anesthesiology 2001;95:334\u20139.","DOI":"10.1097\/00000542-200108000-00012"}],"container-title":["Scandinavian Journal of Pain"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.degruyter.com\/view\/j\/sjpain.2018.18.issue-4\/sjpain-2018-0073\/sjpain-2018-0073.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/sjpain-2018-0073\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/sjpain-2018-0073\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T12:55:23Z","timestamp":1765284923000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/sjpain-2018-0073\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,22]]},"references-count":8,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2018,7,27]]},"published-print":{"date-parts":[[2018,10,25]]}},"alternative-id":["10.1515\/sjpain-2018-0073"],"URL":"https:\/\/doi.org\/10.1515\/sjpain-2018-0073","relation":{},"ISSN":["1877-8879","1877-8860"],"issn-type":[{"value":"1877-8879","type":"electronic"},{"value":"1877-8860","type":"print"}],"subject":[],"published":{"date-parts":[[2018,6,22]]}}}