Reactions 1499, p9 - 3 May 2014

SBupivacaine

Horner’s syndrome: case reportA 29-year-old man developed Horner’s syndrome while

receiving bupivacaine.The man, who had a left shoulder Bankart lesion, was

scheduled for a elective arthroscopic surgery. Initially, hereceived pre-operative anaesthesia with 10ml of 0.25%bupivacaine, which was injected into the interscalene space.Subsequently, a 20 gauge catheter was inserted into his skin toa depth of 10cm and general anaesthesia was induced. Thesurgery was performed uneventfully. Eight hours after theinitial bolus, his analgesia was maintained with 10ml of 0.2%bupivacaine, administered every 8 hours through theinterscalene catheter. After 1 hour, he developed Horner’ssyndrome on the ipsilateral side. Symptoms included meiosis,ptosis, enophthalmia, anhydrosis and conjunctivalhyperaemia.

Consequently, the man’s catheter was withdrawn, and hissymptoms disappeared approximately 2 hours later.Subsequently, the analgesia was replaced by paracetamol andNSAIDs.

Author comment: "We describe a case of Horner’ssyndrome that occurred shortly after post-operative bolusadministration of interscalene brachial plexus analgesia."Alzahrani T, et al. Delayed Horner’s syndrome following ultrasound-guidedinterscalene brachial plexus block. Saudi Journal of Anaesthesia 8: 121-123, No. 1,Jan-Mar 2014. Available from: URL: http://doi.org/10.4103/1658-354X.125972 -Saudi Arabia 803102638

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Reactions 3 May 2014 No. 14990114-9954/14/1499-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved