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British Journal of Anaesthesia, 2001, Vol. 86, No. 2 280-282
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Total spinal anaesthesia in association with insertion of a paravertebral catheter

B. Lekhak, C. Bartley, I. D. Conacher* and S. M. Nouraei

Cardiothoracic Unit, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK*Corresponding author: Department of Cardiothoracic Anaesthesia, Freeman Hospitals NHS Trust, Newcastle upon Tyne NE7 7DN, UK

An association between intercostal nerve block and the development of a total spinal is rare. Usually, subarachnoid injection is considered to have followed intraneural placement or inadvertent entrance into a dural cuff extending beyond an intervertebral foramen. We report a patient that followed injection of local anaesthetic into a paravertebral catheter sited at surgery in the thoracic paravertebral space of a patient undergoing thoracotomy. This was a life-threatening event that occurred on two occasions before the definitive diagnosis was made. It is considered likely that the paravertebral catheter entered an intervertebral foramen and the tip perforated the dura.

Br J Anaesth 2001; 86: 280–2


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