[Anatomical consideration of anesthetic dispersion into abdominal cavity causing broad unilateral anesthesia after inadvertent local anesthetic infusion into endothoracic fascia].
Recently we reported a case of inadvertent migration of an epidural catheter into the endothoracic fascia. Anesthetic injection into the fascia brought a broad unilateral analgesia. To clarify the mechanism of anesthesia. We studied how the anesthetic agent spreads into the abdominal cavity from the endothoracic fascia. The crimson dye, the substitute of the anesthetic agent, reached the transversial fascia in the abdominal cavity through medial and lateral arcuate ligament. Subcostal nerve, iliohypogastric nerve, ilioinguinal nerve, genitofemoral nerve and lateral femoral cutaneous nerve were found to be in the course of dye dispersion. The renal adiposal fascia plays a role of a reservoir for the anesthetic agent and prevents the further anesthetic dispersion.
Saito
T
T
Department of Anesthesiology, Nippon Medical School, Tokyo.
Tanuma
K
K
Yamada
K
K
Ogawa
R
R
D000005:Abdomen / Q000294:innervation*; D000777:Anesthetics / Q000008:administration & dosage / Q000493:pharmacokinetics*; D002102:Cadaver; D005205:Fascia; D006801:Humans; D007267:Injections; D013909:Thorax
D000777:Anesthetics