Case reportInadvertent Total Spinal Anesthesia After Intercostal Nerve Block Placement During Lung Resection
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Comment
At thoracotomy, direct injection of local anaesthetic in the form of intercostal blocks or by catheters is generally without complications and results in good analgesia as a part of a multimodal approach to postoperative analgesia [3]. Our practice is to use epidural analgesia with a combination of nonsteroidal anti-inflammatory drugs and intercostal blocks. When epidural placement is not possible, this is substituted by opiate analgesia, usually by continuous or patient-controlled infusions.
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Cited by (16)
Postoperative pain management: Truncal blocks in thoracic surgery
2021, Features and Assessments of Pain, Anesthesia, and AnalgesiaDelayed emergence after anesthesia
2015, Journal of Clinical AnesthesiaCitation Excerpt :Another possibility for delayed emergence with neurological symptoms such as paralysis is total spinal anesthesia. There are reports where patients were hypotensive, slow to wake up, showed complete paralysis and little to no breathing effort [54,55] after thoracic procedures. Chaudri et al [54] report a patient that failed to wake up after thoracotomy and had fixed and dilated pupils, complete paralysis, and made no respiratory effort.
Intercostal Nerve Block
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