Documented arterial gas embolism after spinal epidural injection.
We report the case of a 90-year-old man with syncope, arrhythmia, cardiac ischemia, and neurologic deficit after undergoing spinal epidural injection for control of pain related to post-herpetic neuralgia. The diagnosis of arterial gas embolus was made after air was identified in the left ventricle of the heart on an abdominal computed tomographic scan. Emergency physicians should consider and rapidly diagnose this rare but potentially fatal complication of spinal epidural puncture.
MacLean
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Department of Emergency Medicine, Maine Medical Center, Portland, ME 04102, USA. maclec@mail.mmc.org
Bachman
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DT
D000368:Aged; D015360:Analgesia, Epidural / Q000009:adverse effects*; D001623:Betamethasone; D002045:Bupivacaine; D003937:Diagnosis, Differential; D004618:Embolism, Air / Q000000981:diagnostic imaging* / Q000628:therapy; D004636:Emergency Service, Hospital; D006352:Heart Ventricles / Q000000981:diagnostic imaging*; D006562:Herpes Zoster / Q000188:drug therapy*; D006801:Humans; D007268:Injections, Epidural / Q000009:adverse effects*; D008297:Male; D010102:Oxygen Inhalation Therapy; D014057:Tomography, X-Ray Computed
D001623:Betamethasone; D002045:Bupivacaine