[Bilateral polyradiculitis after an epidural block: a rare, serious complication].
Permanent neurological complications related to neuraxial techniques are rare. We report a case in which performance of the regional block and the intervention were free of noteworthy incidents. Postoperative pain was controlled by use of multimodal analgesia. The epidural catheter was removed on the ward after 24 hours. However, 72 hours after the intervention, the patient developed lower limb weakness and associated paresthesia mainly on the right side. Examination disclosed flaccid paralysis from the second lumbar vertebra affecting mainly the right lower extremity with no involvement of the sphincters. Emergency magnetic resonance imaging was negative for masses occupying the spinal canal. After a battery of tests over the following days (electromyography, lumbar puncture, and magnetic resonance imaging), bilateral polyradiculitis related to epidural analgesia was diagnosed. The clinical course was satisfactory, though resolution was slow. Electromyography at 8 months confirmed clear improvement in lesions. After a year, the patient continued rehabilitation and occasionally still used a cane.
Mira
M D
MD
Unidad de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Fundación Son Llátzer, Carretera de Manacor, s/n. km. 4, 07198 Palma de Mallorca. lola.mira@terra.es
Peláez
R
R
Segura
M C
MC
Ferrer
A M
AM
Aguilar
J L
JL
D015360:Analgesia, Epidural / Q000009:adverse effects*; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006406:Hematoma / Q000209:etiology; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000503:physiopathology; D007580:Jejunal Neoplasms / Q000601:surgery; D008012:Lidocaine / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009123:Muscle Hypotonia / Q000209:etiology / Q000503:physiopathology; D010149:Postoperative Pain / Q000517:prevention & control; D010264:Paraplegia / Q000209:etiology* / Q000503:physiopathology; D010292:Paresthesia / Q000209:etiology; D011128:Polyradiculopathy / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D013116:Spinal Cord / Q000098:blood supply; D013117:Spinal Cord Compression / Q000209:etiology / Q000503:physiopathology; D013126:Spinal Nerve Roots / Q000293:injuries*
D000779:Anesthetics, Local; D008012:Lidocaine