Journal of clinical anesthesia
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A case of temporary quadriplegia following a continuous thoracic paravertebral block in an adult patient scheduled for video-assisted thoracoscopy is presented. An 18-gauge Tuohy needle was inserted under direct vision by the surgeon but the tip of the catheter was not localized. Postoperatively, the patient developed temporary quadriplegia 90 minutes after the start of a continuous infusion of ropivacaine 0.2%. Imaging studies showed that the catheter was localized in the intrathecal space.
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To determine the exact mechanism underlying spinal anesthesia-induced hypotension in the elderly patient. ⋯ A decrease in SVR, not CO, is the main mechanism of hypotension seen during spinal anesthesia in elderly patients.