J Korean Pain Soc.  1996 Jun;9(1):260-263.

High Spinal Block following Epidural Block for Postoperative Pain Control: A case report

Affiliations
  • 1Department of Anesthesiology, Pain Clinic, College of Medicine, Chonnam National University, Kwangju, Korea.
  • 2College of Dentistry, Chonnam National University, Kwangju, Korea.

Abstract

High spinal block is a rare complication during epidural block, but it may result in serious events. 56-year-old man with gall stones was scheduled for cholecystectomy under general anesthesia. After operation, lumbar epidural catheterization was done at T8-9 interspace for postoperative pain control. At the recovery room, initial bolus drug (0.1% bupivacaine IOml containing fentanyl 100 microgram) was administered via epidural catheter and observed carefully. 15 minutes later, hypotension and bradycardia occurred. Hartman' solution was administered rapidly and ephedrine 5 mg was injected. 30 minutes after drug administration, loss of consciousness and respiratory arrest developed. Tracheal intubation was done immediately. Cardiovascular and respiratory functions were monitored continuously. The location of intrathecal catheter was confirmed by cerebrospinal fluid (CSF) seen in syringe after aspiration of catheter. The patient recovered gradually and was placed in the ward 4 hours after drug administration, without any problems. He was discharged I week later in good health.

Keyword

Epidural block; High spinal block; Postoperative pain control

MeSH Terms

Anesthesia, General
Bradycardia
Bupivacaine
Catheterization
Catheters
Cerebrospinal Fluid
Cholecystectomy
Ephedrine
Fentanyl
Gallstones
Humans
Hypotension
Intubation
Middle Aged
Pain, Postoperative*
Recovery Room
Syringes
Unconsciousness
Bupivacaine
Ephedrine
Fentanyl
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