title: Partial sensory and motor deficit of ipsilateral lower limb after continuous interscalene brachial plexus block.
abstract: We describe a partial sensory and motor block of the ipsilateral lower limb after interscalene infusion. After and injection of 20 mL of ropivacaine through the needle, the catheter was advanced 5 cm, and an infusion of ropivacaine 0.2% 5 mL/h commenced. Six hours later, the patient reported a left sensory and motor hemisyndrome, which resolved after the infusion was discontinued. Cervical computed tomography showed the tip of the catheter close to the intervertebral foramen at the C7-T1 level and several intravertebral paramedullar air bubbles. We conclude that the neurological symptoms were caused by an injection of local anesthetic via an interscalene catheter placed in proximity to the epidural space. To avoid this complication, we recommend advancing the catheter no more than 2-3 cm and performing frequent neurological evaluation of patients.
authors.affiliation: Division of Anesthesiology, University Hospitals of Geneva, Switzerland. alexandre.faust@hcuge.ch
authors.forename: A
authors.initials: A
authors.lastname: Faust
authors.forename: R
authors.initials: R
authors.lastname: Fournier
authors.forename: O
authors.initials: O
authors.lastname: Hagon
authors.forename: P
authors.initials: P
authors.lastname: Hoffmeyer
authors.forename: Z
authors.initials: Z
authors.lastname: Gamulin
mesh_terms: D000328:Adult; D000577:Amides / Q000009:adverse effects; D001917:Brachial Plexus / Q000000981:diagnostic imaging / Q000187:drug effects*; D002404:Catheterization / Q000009:adverse effects; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000000981:diagnostic imaging*; D019957:Motor Skills Disorders / Q000139:chemically induced* / Q000000981:diagnostic imaging; D009407:Nerve Block / Q000009:adverse effects*; D009475:Neurons, Afferent / Q000000981:diagnostic imaging / Q000187:drug effects; D011859:Radiography; D000077212:Ropivacaine; D012678:Sensation Disorders / Q000139:chemically induced* / Q000000981:diagnostic imaging
chemical_list: D000577:Amides; D000077212:Ropivacaine