Reactions 1155 - 9 Jun 2007

Fentanyl/ropivacaine/sufentanil

Plexopathy following lumbar epidural analgesia:case report

A 30-year-old woman developed left-leg plexopathy afterreceiving epidural analgesia with sufentanil, ropivacaine andfentanyl.

The woman presented in spontaneous labour and receivedepidural analgesia with intrathecal sufentanil 10µg followed byan infusion of fentanyl 2µg/mL and 0.2% ropivacaine [dosagenot clearly stated]. Following delivery of an infant after a12-hour labour, she had persistent weakness of her plantarflexors and left quadriceps along with a decreased sensation ina stocking glove distribution. The next day, she wasambulatory, but her weakness persisted. She had absent ankleand knee reflexes. Her symptoms were consistent with left-legplexopathy.

The woman underwent physical therapy and long-termneurology follow-up. After 8 weeks, she had +1 ankle andknee reflexes. At 4 months, her symptoms recurred, butsubsequently improved; the symptoms worsened withoveruse and fatigue. At 6 months, she had a persistent, mildleft femoral neuropathy.

Author comment: "Our supposition is that as with thephysiologic neurological disorders, mechanical neuralimpairment can be exacerbated by regional anesthesia."Criser A, et al. Post partum left lower extremity plexopathy after lumbar epiduralanalgesia for labor. Anesthesiology 106 (Suppl. 1): 93 abstr. A-170, 16 May 2007- USA 801076729

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Reactions 9 Jun 2007 No. 11550114-9954/10/1155-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved