Persistent cortical blindness after a thoracic epidural test dose of bupivacaine.
Thoracic epidural anesthesia is considered as an essential component of the perioperative care for patients undergoing lung resection. Although neurologic adverse events have been associated with this technique, permanent injury is rare. These events primarily involve the peripheral nervous system; for example, nerve root injury. We present a case of persistent cortical blindness after a test dose of bupivacaine was administered into an uneventfully placed thoracic epidural catheter.
Visser
W Anton
WA
Department of Anesthesiology, Amphia Hospital, Breda, The Netherlands. avisser@amphia.nl
Kolling
Joy Bach
JB
Groen
Gerbrand J
GJ
Tetteroo
Eric
E
van Dijl
Ron
R
Rosseel
Peter M J
PM
van der Meer
Nardo J M
NJ
D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects*; D019575:Blindness, Cortical / Q000139:chemically induced*; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects*; D018287:Carcinoma, Large Cell / Q000601:surgery; D002404:Catheterization; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013131:Spine / Q000473:pathology
D000779:Anesthetics, Local; D002045:Bupivacaine