Perioperative stroke associated with postoperative epidural analgesia

Christopher L. Wu, David R. Francisco, Curtis G. Benesch

Research output: Contribution to journalArticlepeer-review

Abstract

A patient with an epidural catheter for postoperative analgesia developed a stroke in association with a hypotensive episode resulting from a bolus of local anesthetic. After undergoing resection for femoral chondrosacroma under epidural anesthesia, the patient received a continuous infusion of epidural morphine for postoperative analgesia. Lidocaine 1% (10 mL in divided doses) was administered through the catheter for breakthrough pain. The patient experienced a hypotensive episode and was noted to have a motor and cortical sensory deficit of the left arm and leg 8 hours after the hypotensive episode. Clinical presentation and subsequent workup were consistent with a watershed infarction. The patient recovered full neurologic function before discharge. Postoperative hypotension from epidural analgesia may be associated with stroke; however, a cause-and-effect relationship usually cannot be established with certainty. Copyright (C) 2000 Elsevier Science Inc.

Original languageEnglish (US)
Pages (from-to)61-63
Number of pages3
JournalJournal of Clinical Anesthesia
Volume12
Issue number1
DOIs
StatePublished - Feb 1 2000

Keywords

  • Analgesia
  • Epidural
  • Hypotension
  • Stroke
  • Watershed infarction

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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