Total Spinal Block after Thoracic Paravertebral Block
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Case Report
P: 43-45
February 2014

Total Spinal Block after Thoracic Paravertebral Block

Turk J Anaesthesiol Reanim 2014;42(1):43-45
1. Sakarya Üniversitesi Tıp Fakültesi, Anestezi ve Reanimasyon Anabilim Dalı, Sakarya, Türkiye
2. Sakarya Üniversitesi Eğitim ve Araştırma Hastanesi, Anestezi ve Reanimasyon Kliniği, Sakarya, Türkiye
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Received Date: 08.01.2013
Accepted Date: 05.02.2013
Publish Date: 29.08.2013
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ABSTRACT

Thoracic paravertebral block (TPVB) can be performed with or without general anaesthesia for various surgical procedures. TPVB is a popular anaesthetic technique due to its low side effect profile and high analgesic potency. We used 20 mL of 0.5% levobupivacaine for a single injection of unilateral TPVB at the T7 level with neurostimulator in a 63 year old patient with co-morbid disease who underwent cholecystectomy. Following the application patient lost consciousness, and was intubated. Haemodynamic instability was normalised with rapid volume replacement and vasopressors. Anaesthetic drugs were stopped at the end of the surgery and muscle relaxant was antagonised. Return of mucle strenght was shown with neuromuscular block monitoring. Approximately three hours after TPVB, spontaneous breathing started and consciousness returned. A total spinal block is a rare and life-threatening complication. A total spinal block is a complication of spinal anaesthesia, and it can also occur after peripheral blocks. Clinical presentation is characterised by hypotension, bradicardia, apnea, and cardiac arrest. An early diagnosis and appropriate treatment is life saving. In this case report, we want to present total spinal block after TPVB.