Neuropathic pain after epidural needle trauma.
OBJECTIVE
Neurologic complications secondary to epidural block are uncommon. Direct mechanical trauma to nerve roots may cause neuropathic pain that, usually, has a favorable evolution; however, it is a potentially severe complication that can evolve into a chronic disorder. The objective of this study was to discuss acute traumatic neuropathic pain and, especially, its treatment.


METHODS
A male patient was admitted for surgical treatment of gastroesophageal reflux via laparoscopy and scheduled to be discharged on the first postoperative (PO) day. He underwent epidural block associated with general anesthesia. During the localization of the epidural space, the patient complained of severe pain in the left lower limb. The needle was repositioned and the epidural space was located. In the PO, the patient developed allodynia and hyperesthesia. Neuropathic pain was diagnosed. Treatment included antidepressant, anticonvulsant, corticosteroids, tramadol, and vitamin B complex. On the 28th PO the patient was asymptomatic and presented a normal physical exam, being discharged from the hospital.


CONCLUSIONS
The patient presented a favorable evolution with the treatment instituted. Early diagnosis and treatment can avoid irreversible lesions, change the prognosis, and avoid social and medical-legal consequences.
Ramos
Gilson Cassem
GC
Serviço de Anestesia do Hospital Samaritano de Goiânia, GO. gilson.ramos@terra.com.br
Gomes
Eduardo Custódio de O
EC
D000767:Anesthesia, Epidural / Q000009:adverse effects* / Q000295:instrumentation; D006801:Humans; D008297:Male; D009339:Needles; D009437:Neuralgia / Q000209:etiology*; D013126:Spinal Nerve Roots / Q000293:injuries*; D055815:Young Adult