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Ann Thorac Surg 1976;22:289-292
© 1976 The Society of Thoracic Surgeons

Articles

Total Spinal Anesthesia

A Rare Complication of Intrathoracic Intercostal Nerve Block

Charles W. Otto, M.D.*, Conrad L. Wall, M.D.

Departments of Anesthesiology and Internal Medicine, University of Arizona College of Medicine, Tucson, AZ.

Accepted for publication January 12, 1976.

* Address reprint requests to Dr. Otto, Department of Anesthesiology, University of Arizona College of Medicine, Tucson, AZ 85724.

Total spinal anesthesia following intrathoracic intercostal nerve blocks with bupivacaine performed for postoperative pain relief during thoracotomy is described. Possible mechanisms for this complication include: (1) inadvertent placement of the needle through an intervertebral foramen, (2) puncture of a long dural cuff, and (3) intraneural injection with central spread. Recognition of this potential complication is important, and facilities for proper support must be available.




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