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KMID : 1040020200110020056
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International Journal of Pain
2020 Volume.11 No. 2 p.56 ~ p.60
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Severe Hypotension after Thoracic Paravertebral Block due to Epidural Spread: A Case Report
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Chae Ji-Seon
Kim Dae-Hyun
Lim Jeong-Ae
Lee Joon
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Abstract
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We report a case of severe hypotension that occurred subsequent to a left thoracic paravertebral block (TPVB) in a 65-year-old man who underwent a thoracotomy one month before presentation. In addition to hypotension, he experienced motor weakness in his left leg. The patient was treated, stabilized, and eventually discharged. Two months after the first procedure, when the TPVB was to be repeated, the cause of the hypotension was identified as an inadvertent epidural spread. This spread was determined by injecting contrast medium into the respective thoracic paravertebral spaces prior to the local anesthetic injection. Once the cause of hypotension was identified, effective remedial measures could be taken. While performing the TPVB, we should be mindful of the spread of the local anesthetic drugs into the epidural or other spaces, and of the associated complications.
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KEYWORD
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hypotension, paravertebral block, regional anesthesia, thoracic epidural block, thoracic wall pain
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