[Total spinal anesthesia after posterior lumbar plexus block].
We report a case of total spinal anaesthesia which occurred after a lumbar plexus block using a posterior approach. After total hip arthroplasty under general anaesthesia, a lumbar plexus block was performed according to Winnie's landmarks at the L4 interspace using a nerve stimulator. Aspiration test for blood and spinal fluid were both negative, as well as a test dose of 3 mL lidocaine 2%-bupivacaine 0.5%. One minute after the injection of 27 mL of the same mixture, a complete anaesthetic block occurred with hypotension and loss of consciousness requiring intubation and controlled ventilation during 3h30, without sequelae. Lumbar plexus block using a posterior approach must be performed cautiously and a slow and fractionated injection of the full dose is recommended.
Gentili
M
M
Département d'anesthésie-réanimation 2, CMC Saint-Vincent, Paris, France.
Aveline
C
C
Bonnet
F
F
D000368:Aged; D000775:Anesthesia, Spinal; D019644:Arthroplasty, Replacement, Hip; D006801:Humans; D007022:Hypotension / Q000209:etiology; D008160:Lumbosacral Plexus; D008297:Male; D009407:Nerve Block / Q000009:adverse effects*; D012121:Respiration, Artificial; D014474:Unconsciousness / Q000139:chemically induced