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Ann Fr Anesth Reanim · Jan 1998
Case Reports[Total spinal anesthesia after posterior lumbar plexus block].
- M Gentili, C Aveline, and F Bonnet.
- Département d'anesthésie-réanimation 2, CMC Saint-Vincent, Paris, France.
- Ann Fr Anesth Reanim. 1998 Jan 1; 17 (7): 740-2.
AbstractWe report a case of total spinal anaesthesia which occurred after a lumbar plexus block using a posterior approach. After total hip arthroplasty under general anaesthesia, a lumbar plexus block was performed according to Winnie's landmarks at the L4 interspace using a nerve stimulator. Aspiration test for blood and spinal fluid were both negative, as well as a test dose of 3 mL lidocaine 2%-bupivacaine 0.5%. One minute after the injection of 27 mL of the same mixture, a complete anaesthetic block occurred with hypotension and loss of consciousness requiring intubation and controlled ventilation during 3h30, without sequelae. Lumbar plexus block using a posterior approach must be performed cautiously and a slow and fractionated injection of the full dose is recommended.
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