Mejía-Terrazas GE, Áreas-Santiago M, Lavín-Lozano A, Mille-Loera E

Language: Spanish
References: 17
Page: 180-184
PDF size: 65.48 Kb.

ABSTRACT

Introduction: Injuries to peripheral nerves has been reported in various medical conditions and surgical settings. Physicians should be aware of them, especially those presenting in the postoperative period, since they may be associated to techniques of regional anesthesia. Case report: A 47-year-old female with diagnosis of ovarian cancer underwent a laparotomy under mixed blockade. The procedure was completed uneventfully. Three days after surgery, the patient was reported to have neurological symptoms involving the left lower limb, including severe pain, paresis and hypoesthesia, probably related to the anesthetic procedure. On examination, hypoesthesia was found on the inner aspect of the left thigh, as well as hyperalgesia, mechanical and thermal allodynia on the anterior aspect of the left thigh, and hyperesthesia on the anterolateral aspect of the left thigh. Muscle examination revealed paresis of muscles supplied by the femorocutaneous, the obturator and the femoral nerves.Deep tendon reflexes: The left patellar reflex could not be elicited because of pain. The right patellar reflex and Achilles reflex were normal. Bowel and bladder sphincters were normal. Neuropathy of the femorocutaneous, obturator and femoral nerves was diagnosed; it was treated with tramadol and carbamazepine. Four weeks later, only hypoesthesia of the inner thigh persisted. Four months later, all symptoms had resolved. Discussion: Neurological injuries due to spinal anesthesia techniques are usually bilateral, with both sensory and motor involvement, bowel and bladder incontinence and sexual dysfunction. A unilateral, well localized nerve injury virtually rules out a spinal cord injury.

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