Subdural, extra-arachnoid block as a complication of stellate ganglion block: documentation with ultrasound

Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
S KapralC Weinstabl

Abstract

We present a patient who developed a high central neural block after stellate-ganglion-blockade. The underlying pathophysiology was assessed via sonographic imaging. Stellate ganglion block was performed in a 19-year old patient according to the standard technique. Multiple aspiration tests were negative and a test dose of 3 ml bupivacaine 0.25% was injected. After a 3 min interval another 5 ml were injected. Two minutes after the local anaesthetic administration the patient reported nausea and sensations in the upper extremity. Spontaneous respiration efforts stopped, and the patient became unconscious. Tracheal intubation was performed, and the patient was ventilated in a controlled mode for two hours. Heart rate as well as blood pressure remained within the normal range. Neurologic recovery occurred rapidly and extubation was performed about two and a half hours after the event. Our sonographic studies demonstrated a local anaesthetic depot directly at the root of C 6, with a mean diameter of 10 mm and a length of 5 to 6 cm (about a third smaller than expected). Sonographic studies and clinical symptoms of our patient are most likely to occur with a subdural extra-arachnoidal block. Ultrasonographic guided puncture enhances ...Continue Reading

Citations

Dec 30, 2014·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Karin WeiJustus Benrath
Dec 19, 2006·Pain Practice : the Official Journal of World Institute of Pain·Ashok K SaxenaAshok K Sethi

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