Reactions 1354 - 4 Jun 2011

Fentanyl/ropivacaine

Horner’s syndrome and brachial plexus blockfollowing epidural administration: case report

A 30-year-old woman developed Horner’s syndrome andbrachial plexus block after receiving fentanyl andropivacaine for epidural anaesthesia during labour.

The woman presented in labour and underwent epiduralanaesthesia. The catheter was inserted into the L2-L3 spaceand she received an initial dose of 0.2% ropivacaine 9mLand fentanyl 50µg. After 15 minutes, the sensory block hadreached T10. She started receiving a perfusion of 0.2%ropivacaine and fentanyl 1 µg/mL at 8 mL/hour. After8 hours, it was decided to perform a caesarean sectionbecause of failure to progress. In the operating theatre, shereceived 0.75% ropivacaine 10mL via puncture, whichachieved an effective block of the T4-S5 dermatomes. Thecaesarean section began after 15 minutes and took30 minutes, and when she was transferred to the recoveryroom, she was found to have loss of strength in her rightarm along with palpebral ptosis and miosis of her right eye.She was diagnosed with right Horner’s syndrome and rightbrachial plexus block secondary to high epidural block,reaching right T4-S5 (sensory) and C4-S5 (motor). Sheremained in the observation room; the right brachial plexusblock reverted spontaneously after an hour and the rightHorner’s syndrome after four hours.Molins Ballabriga G, et al. [Horner syndrome and brachial plexus blockade afterepidural anesthesia for obstetric labor and cesarean section]. [Spanish]. RevistaEspanola de Anestesiologia Y Reanimacion 58: 54-6, No. 1, Jan 2011 [Spanish;summarised from a translation] - Spain 803054946

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Reactions 4 Jun 2011 No. 13540114-9954/10/1354-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved