Persistent Cortical Blindness after a Thoracic Epidural Test Dose of Bupivacaine

Thoracic epidural anesthesia is considered as an essential component of the perioperative care for patients undergoing lung resection. Although neurologic adverse events have been associated with this technique, permanent injury is rare. These events primarily involve the peripheral nervous system;...

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Bibliographic Details
Published in:Anesthesiology (Philadelphia) 2010-02, Vol.112 (2), p.493-495
Main Authors: VISSER, W. Anton, KOLLING, Joy Bach, GROEN, Gerbrand J, TETTEROO, Eric, VAN DIJL, Ron, ROSSEEL, Peter M. J, VAN DER MEER, Nardo J. M
Format: Article
Language:English
Subjects:
Anesthesia
Anesthesia, Epidural - adverse effects
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Anesthetics, Local - administration & dosage
Anesthetics, Local - adverse effects
Biological and medical sciences
Blindness, Cortical - chemically induced
Bupivacaine - administration & dosage
Bupivacaine - adverse effects
Carcinoma, Large Cell - surgery
Catheterization
Female
Humans
Lung Neoplasms - surgery
Magnetic Resonance Imaging
Medical sciences
Middle Aged
Spine - pathology
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Description
Summary:Thoracic epidural anesthesia is considered as an essential component of the perioperative care for patients undergoing lung resection. Although neurologic adverse events have been associated with this technique, permanent injury is rare. These events primarily involve the peripheral nervous system; for example, nerve root injury. We present a case of persistent cortical blindness after a test dose of bupivacaine was administered into an uneventfully placed thoracic epidural catheter.
ISSN:0003-3022
1528-1175
DOI:10.1097/ALN.0b013e3181c5387a