Reactions 1315 - 21 Aug 2010

SMepivacaine

Subdural block in an elderly patient: case reportA 68-year-old woman was admitted with pain associated

with herpes zoster of her right T5 region. A continuousepidural block was started with 1% mepivacaine 3mL,followed by a continuous ropivacaine infusion withperiodic 1% mepivacaine 3mL injections five times daily.After 15 days of continuous epidural block, ropivacaine waswithdrawn and thrice daily mepivacaine was continued. Onday 21, she developed weakness and loss of sensation inher left limbs with Horner’s syndrome 10 minutes after herthird daily mepivacaine injection; the right side of her bodyremained normal. Her symptoms resolved spontaneouslywithin 120 minutes. Subdural block was diagnosed, andher catheter was removed. She was discharged withoutsequelae on day 23.

Author comment: Although the catheter was in theepidural space at the time of insertion, it is thought that ithad migrated into the subdural space 21 days later.Goto H, et al. Subdural block which appeared 21 days after beginning continuousepidural block. Masui. The Japanese Journal of Anesthesiology 59: 498-500, No. 4,Apr 2010 [Japanese; summarised from a translation] - Japan 803034170

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Reactions 21 Aug 2010 No. 13150114-9954/10/1315-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved