title: Total Spinal Block after Thoracic Paravertebral Block.
abstract: Thoracic paravertebral block (TPVB) can be performed with or without general anaesthesia for various surgical procedures. TPVB is a popular anaesthetic technique due to its low side effect profile and high analgesic potency. We used 20 mL of 0.5% levobupivacaine for a single injection of unilateral TPVB at the T7 level with neurostimulator in a 63 year old patient with co-morbid disease who underwent cholecystectomy. Following the application patient lost consciousness, and was intubated. Haemodynamic instability was normalised with rapid volume replacement and vasopressors. Anaesthetic drugs were stopped at the end of the surgery and muscle relaxant was antagonised. Return of mucle strenght was shown with neuromuscular block monitoring. Approximately three hours after TPVB, spontaneous breathing started and consciousness returned. A total spinal block is a rare and life-threatening complication. A total spinal block is a complication of spinal anaesthesia, and it can also occur after peripheral blocks. Clinical presentation is characterised by hypotension, bradicardia, apnea, and cardiac arrest. An early diagnosis and appropriate treatment is life saving. In this case report, we want to present total spinal block after TPVB.
authors.affiliation: Department of Anaesthesiology and Reanimation, Faculty of Medicine, Sakarya University, Sakarya, Turkey.
authors.forename: Serbülent Gökhan
authors.initials: SG
authors.lastname: Beyaz
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Sakarya University Training and Research Hospital, Sakarya, Turkey.
authors.forename: Hande
authors.initials: H
authors.lastname: Özocak
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Sakarya University Training and Research Hospital, Sakarya, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Ergönenç
authors.affiliation: Department of Anaesthesiology and Reanimation, Faculty of Medicine, Sakarya University, Sakarya, Turkey.
authors.forename: Ali Fuat
authors.initials: AF
authors.lastname: Erdem
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Sakarya University Training and Research Hospital, Sakarya, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Palabıyık
keywords: Regional anaesthesia; complication; paravertebral block