title: [Horner syndrome and brachial plexus blockade after epidural anesthesia for obstetric labor and cesarean section].
abstract: A 30-year-old woman (ASA II, obese) in her 40th week of a first pregnancy required epidural analgesia for labor. When the cervix had dilated to 5 cm, the epidural infusion was started with a 9-mL bolus of 0.2% ropivacaine and 50 pg of fentanyl, after a negative test dose. An infusion of 0.2% ropivacaine and 1 microg/mL of fentanyl was started at a rate of 8 mL/h. A cesarean section was required after insufficient progress was made during 8 hours of labor. Eight milliliters of 0.75% ropivacaine was administered to provide anesthesia to T4; cesarean delivery was completed without complications. Early during postoperative recovery, in addition to motor blockade of the legs, the patient experienced a right brachial plexus blockade and Horner syndrome on the same side. Both effects disappeared spontaneously (1 and 4 hours later, respectively).
authors.affiliation: Departamento de Anestesiologia, Reanimación y Tratamiento del Dolor, Instituto Universitario Dexeus, Barcelona. gmolins@hotmail.com
authors.forename: G
authors.initials: G
authors.lastname: Molins Ballabriga
authors.forename: Y
authors.initials: Y
authors.lastname: Vacas
authors.forename: F
authors.initials: F
authors.lastname: Jiménez
authors.forename: R
authors.initials: R
authors.lastname: Borras
authors.forename: J
authors.initials: J
authors.lastname: Mailan
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D020516:Brachial Plexus Neuropathies / Q000209:etiology*; D002585:Cesarean Section; D005260:Female; D006732:Horner Syndrome / Q000209:etiology*; D006801:Humans; D011247:Pregnancy