Inadvertent total spinal anesthesia after intercostal nerve block placement during lung resection.
Intercostal nerve block is a recognized way of providing analgesia at thoracotomy. There is a rare association between intercostal nerve block and the complication of total spinal anesthesia. This may arise inadvertently by injection into a dural cuff extending outside the intervertebral foramen. We report our experience with a patient who sustained this life-threatening complication. The patient required postoperative ventilation until the neurologic deficits resolved. The operator must be aware that intercostal nerve block runs the rare but potentially fatal risk of total spinal block.
Chaudhri
Babar B
BB
Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom. bchaudhri@mac.com
Macfie
Alistair
A
Kirk
Alan J
AJ
D000368:Aged; D000775:Anesthesia, Spinal; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007268:Injections, Epidural; D007367:Intercostal Nerves / Q000187:drug effects; D008175:Lung Neoplasms / Q000473:pathology / Q000601:surgery; D008297:Male; D009407:Nerve Block / Q000009:adverse effects*; D010146:Pain / Q000517:prevention & control; D010243:Paralysis / Q000139:chemically induced* / Q000503:physiopathology; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods; D020127:Recovery of Function; D018570:Risk Assessment; D012720:Severity of Illness Index; D013908:Thoracotomy / Q000009:adverse effects* / Q000379:methods; D013997:Time Factors
D002045:Bupivacaine