Document Detail


Two cases of Horner syndrome after administration of an epidural test dose that did not recur with subsequent epidural activation.
MedLine Citation:
PMID:  19574872     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We describe 2 cases of Horner syndrome after epidural test dose injections in thoracic surgery patients. The Horner syndrome was transient and did not recur with full epidural activation and infusion. CASE REPORT: Two patients undergoing thoracic surgery procedures received preoperative midthoracic epidural catheters for postoperative analgesia. Following the 3-mL 1.5% lidocaine test dose, a unilateral Horner syndrome was observed. No other signs and symptoms of high epidural blockade were seen, and the Horner syndrome subsequently resolved. After epidurogram confirmation of proper catheter position and at the conclusion of surgery, the epidural was activated with an appropriate bolus and infusion dose without recurrence of the Horner syndrome. CONCLUSIONS: Two cases of Horner syndrome presenting after administration of an epidural test dose are reported. This uncommon initial finding could not be reproduced with subsequent epidural activation, perhaps suggesting that initial conditions within the epidural space had been altered. Successful utilization of neuraxial regional analgesia was achieved with careful postoperative monitoring of the patients.
Authors:
Nir Hoftman; Karina Chan
Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Regional anesthesia and pain medicine     Volume:  34     ISSN:  1532-8651     ISO Abbreviation:  Reg Anesth Pain Med     Publication Date:    2009 Jul-Aug
Date Detail:
Created Date:  2009-07-03     Completed Date:  2009-10-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9804508     Medline TA:  Reg Anesth Pain Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  372-4     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, David Geffen School of Medicine, UCLA, Ronald Reagan Medical Center, 757 Westwood Plaza, Mail Code 740330, Los Angeles, CA 90095-7403, USA. nhoftman@mednet.ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, Epidural / adverse effects*
Anesthetics, Local / administration & dosage
Funnel Chest / surgery
Horner Syndrome / etiology*
Humans
Injections, Epidural
Intraoperative Complications*
Lidocaine / administration & dosage
Lung Neoplasms / secondary,  surgery
Male
Treatment Outcome
Young Adult
Chemical
Reg. No./Substance:
0/Anesthetics, Local; 137-58-6/Lidocaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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