scholarly journals Horner’s Syndrome with Unilateral Brachial Plexus Blockade Mimicking Cerebrovascular Accident Following Lumbar Combined Spinal Epidural Analgesia for Labor

2019 ◽  
Author(s):  
Richard J Bennett ◽  
Amy Wooten ◽  
Lee Babbel ◽  
Bradley A Reel
Keyword(s):  
Epidural Analgesia ◽  
Brachial Plexus ◽  
Epidural Anesthesia ◽  
Cerebrovascular Accident ◽  
Expectant Management ◽  
Horner’S Syndrome ◽  
Horner's Syndrome ◽  
Lumbar Epidural Anesthesia ◽  
Brachial Plexus Blockade ◽  
Spinal Epidural

Abstract Horner’s Syndrome (HS) with brachial plexus involvement following lumbar epidural anesthesia may be a startling event for the patient and providers. We present a case of Horner’s Syndrome and complete brachial plexus blockade following epidural bolus of lidocaine for labor analgesia that was initially misdiagnosed as a cerebrovascular accident. Use of the catheter was discontinued and the episode resolved with expectant management. This complication is otherwise benign and resolves without sequelae.

scholarly journals Simultaneous Brachial Plexus Block and Combined Two-Segment Spinal-Epidural Anesthesia with Fixation of an Epidural Catheter in the Subcutaneous Canal in a Patient with Polytrauma

2021 ◽  
Vol 10 (3) ◽  
pp. 604-609
Author(s):  
A. P. Marchenko ◽  
O. N. Yamshikov ◽  
S. A. Yemelyanov ◽  
S. A. Mordovin ◽  
A. N. Petrukhin
Keyword(s):  
Epidural Analgesia ◽  
Brachial Plexus ◽  
Epidural Catheter ◽  
Epidural Anesthesia ◽  
Postoperative Period ◽  
Brachial Plexus Block ◽  
Surgical Interventions ◽  
The Right ◽  
Plexus Block ◽  
Spinal Epidural

The article reports an example of the simultaneous use of brachial plexus block and combined two-segment spinal-epidural anesthesia with fixation of an epidural catheter in the subcutaneous canal in an 81-year-old patient after receiving a household injury - closed fracture of the olecranon of the right ulna with displacement of fragments and closed transtrochanteric fracture with a fracture of the right femur fragments. After preoperative preparation and examination, the patient underwent two consecutive surgical interventions within a day: open reduction of comminuted transtrochanteric fracture of the right hip, dynamic femoral screw osteosynthesis and open reduction of fracture of the right olecranon, Weber’s osteosynthesis. Surgical interventions were carried out under regional anesthesia: block of the brachial plexus via supraclavicular access and combined two-segment spinal-epidural anesthesia with a method developed in our clinic for fixing an epidural catheter in the subcutaneous canal using a modified spinal needle. After the operation, the patient underwent postoperative pain relief in the form of epidural analgesia for 72 hours. The postoperative period passed without complications. On the 13th day, the patient was discharged for outpatient treatment by a traumatologist. The use of local anesthesia in the form of two methods of regional anesthesia during two consecutive surgical interventions, in an elderly patient with a high anesthetic risk, followed by long-term postoperative anesthesia in the form of epidural analgesia with a reliable method of epidural catheter fixation in the subcutaneous canal without the use of narcotic analgesics, contributed to the successful carrying out two surgical interventions at once, early activation of the patient, absence of complications in the postoperative period. Reliable catheter fixation is very important for the quality of epidural analgesia. Dislocation of catheters by more than 2 cm can lead to migration of catheters from the epidural space, changing the course of anesthesia, deteriorating its quality, or even interrupting it altogether. The new method of catheter fixation in the subcutaneous canal developed by us made it possible to prevent catheter dislocation.

Transient Horner's syndrome after lumbar epidural anesthesia

Neurology ◽  
1998 ◽  
Vol 51 (5) ◽  
pp. 1473-1475 ◽  
Author(s):  
V. Biousse ◽  
R. A. Guevara ◽  
N. J. Newman
Keyword(s):  
Epidural Anesthesia ◽  
Horner’S Syndrome ◽  
Horner's Syndrome ◽  
Lumbar Epidural Anesthesia

Epidural Anesthesia for Caesarean Section and Occurrence of Horner’s Syndrome

2017 ◽  
Vol 71 (2) ◽  
pp. 128-130
Author(s):  
Sasho Spasovski ◽  
Atanas Sivevski ◽  
Dafina Karadjova ◽  
Igor Samardziski
Keyword(s):  
Epidural Anesthesia ◽  
Empirical Method ◽  
Horner’S Syndrome ◽  
Negative Consequences ◽  
Negative Effects ◽  
Horner's Syndrome ◽  
Gynecology And Obstetrics ◽  
Number Of Patients ◽  
The University

Abstract Recently, specifically in the last decade, at the University Clinic of Gynecology and Obstetrics, the number of patients treated with epidural analgesia for painless childbirth, which in some percentage ends in Caesarian section (35%), has increased. The increased use of the epidural anesthesia and analgesia is due to the fact that it is one of the most popular ways of childbirth today. This situation is a result of the benefits that epidural anesthesia has for the patient, which consist of allowing the pregnant woman to be conscious during childbirth and to feel and see her child coming into the world, accompanied with smaller intensity of intraoperative and postoperative pain. However, the results or the effects in practice have shown that in certain insignificant percentage patients can have negative consequences from the received analgesia (anesthesia) such as: headache, cases of durra puncture, epidural abscess or hematoma, neurological outbursts etc. But, the subject of this analysis or the aim of this study is the appearance of Horner’s syndrome, as one of the negative effects of the epidural anesthesia, which even though rarely (only in 1% of the cases) can appear as a result of the epidural anesthesia. In the case study using the historic, comparative and empirical method we will try through a specific case to determine the causes for the occurrence of the Horner’s syndrome, how it should be treated and what are the consequences for the patient.

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