Exaggerated epidural blockade resulting from unusual spread of bupivacaine in a patient with low back pain.
A 75-year-old woman with chronic low back pain was given bupivacaine and methylprednisolone epidurally through a catheter in the L1-L2 interspace. An unusual spread of bupivacaine resulted in a block from the C4 to the L1 dermatome with no relief of back pain. Injection of a radiopaque dye and subsequent X rays showed a similar spread. The possible causes are discussed.
Popat
M T
MT
Oxford Regional Pain Relief Unit, Abingdon Hospital.
Jadad
A R
AR
Glynn
C J
CJ
D000368:Aged; D000767:Anesthesia, Epidural; D001416:Back Pain / Q000628:therapy*; D002045:Bupivacaine / Q000493:pharmacokinetics*; D002908:Chronic Disease; D003287:Contrast Media / Q000493:pharmacokinetics; D005260:Female; D006801:Humans; D008775:Methylprednisolone
D003287:Contrast Media; D008775:Methylprednisolone; D002045:Bupivacaine