Severe lumbar back pain following epidural injection of local anesthetic for epidural anesthesia. Case report and literature review.
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.
Beers
R A
RA
Department of Anesthesiology, State University of New York Health Science Center, Syracuse 13210, USA.
Thomas
P S
PS
Martin
R J
RJ
Gorji
R
R
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
D000779:Anesthetics, Local; D008619:Mepivacaine