title: Severe lumbar back pain following epidural injection of local anesthetic for epidural anesthesia. Case report and literature review.
abstract: OBJECTIVE
  An epidural anesthetic was planned for a 75-year-old man scheduled for elective femoral-popliteal bypass grafting.
  
  
  METHODS
  Severe and persistent back pain and posterior thigh muscle spasm abruptly began 10 minutes after epidural injection of mepivacaine.
  
  
  RESULTS
  Signs of impending or evolving neurologic injury completely resolved shortly thereafter.
  
  
  CONCLUSIONS
  The worst case scenarios, epidural hematoma and unintentional epidural injection of an irritant, are discussed along with other differential diagnoses. The literature is reviewed to gain insight into this unusual clinical presentation.
authors.affiliation: Department of Anesthesiology, State University of New York Health Science Center, Syracuse 13210, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Beers
authors.forename: P S
authors.initials: PS
authors.lastname: Thomas
authors.forename: R J
authors.initials: RJ
authors.lastname: Martin
authors.forename: R
authors.initials: R
authors.lastname: Gorji
mesh_terms: D000368:Aged; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects*; D001416:Back Pain / Q000139:chemically induced* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage / Q000009:adverse effects*; D010149:Postoperative Pain / Q000139:chemically induced* / Q000503:physiopathology; D013035:Spasm / Q000139:chemically induced / Q000503:physiopathology
chemical_list: D000779:Anesthetics, Local; D008619:Mepivacaine