Lidocaine
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High spinal cord anaesthesia following subdural spread: case report A 40-year-old woman developed high spinal cord anaesthesia following the subdural spread of lidocaine. The woman was scheduled to undergo a right-sided C6 selective cervical nerve root block for a cervical herniated disc. During the procedure, the radiculography extension tube was removed from the spinal needle and a normal extension tube with a syringe containing lidocaine connected in its place. A negative aspiration test was conducted and 1.5mL of 1.0% lidocaine was injected slowly around the C6 nerve root. Immediately after the injection, she reported breathing difficulties, developed acute flaccid paralysis, and became unresponsive. Her blood pressure dropped to 65/46mm Hg and her SpO2 fell to 83%. The woman received oxygen and epinephrine [adrenaline] and her SpO2 and blood pressure improved. A brain CT scan showed air gases. She regained consciousness and became alert after 20 minutes. Her muscle strength normalised and she was discharged the following day. Author comment: "We describe a case of high spinal cord anesthesia that occurred due to the puncture of the epidural sac of the nerve root sleeve with the subdural spread of injected local anesthetic". Tofuku K, et al. Subdural spread of injected local anesthetic in a selective transforaminal cervical nerve root block: A case report. Journal of Medical Case Reports 6: No. 142, Jun 2012. Available from: URL: http:// 803077597 dx.doi.org/10.1186/1752-1947-6-142 - Japan
0114-9954/10/1421-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 29 Sep 2012 No. 1421
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