title: Total spinal anesthesia: a rare complication of intrathoracic intercostal nerve block.
abstract: Total spinal anesthesia following intrathoracic intercostal nerve blocks with bupivacaine performed for postoperative pain relief during thoracotomy is described. Possible mechanisms for this complication include: (1) inadvertent placement of the needle through an intervertebral foramen, (2) puncture of a long dural cuff, and (3) intraneural injection with central spread. Recognition of this potential complication is important, and facilities for proper support must be available.
mesh_terms: D002045:Bupivacaine / Q000009:adverse effects; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects; D007367:Intercostal Nerves; D008875:Middle Aged; D009407:Nerve Block / Q000009:adverse effects*; D059408:Pain Management; D010243:Paralysis / Q000209:etiology*; D011183:Postoperative Complications / Q000628:therapy; D013119:Spinal Cord Injuries / Q000209:etiology*; D013900:Thoracic Nerves; D013903:Thoracic Surgery; D013909:Thorax / Q000601:surgery
chemical_list: D002045:Bupivacaine