Association Between Perioperative Neuraxial Local Anesthetic Neurotoxicity and Arachnoiditis: A Narrative Review of Published Reports
Bibliographic record
Abstract
( Reg Anesth Pain Med . 2024;49:726–750. doi:10.1136/rapm-2023-104941) This review examines the association between neuraxial anesthesia and arachnoiditis, a serious inflammatory condition affecting the pia-arachnoid of the spinal cord and leading to neurologic dysfunction. Due to the severe consequences of arachnoiditis and its complex causes, there is a growing interest in understanding whether local anesthetics contribute to its development. While previous studies have suggested a potential connection, much of the existing literature lacks consistency, is outdated, or fails to isolate local anesthetics as the sole cause. This review systematically analyzed reported cases of arachnoiditis following neuraxial anesthesia, seeking to determine whether an actual causal link exists.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".