Labor Epidural Intolerance Due to a Congenitally Narrowed Spinal Canal.

Abstract:

:Reports exist of severe upper back pain of unknown etiology after administration of large volumes into the epidural space. We present a case of an otherwise healthy parturient who developed severe upper back and neck pain after receiving only a small volume of epidural medication. Magnetic resonance imaging revealed a congenitally narrowed spinal canal because of short pedicle syndrome. Epidural injectate occupies and compresses a percentage of the spinal canal and its neuronal contents. This may result in pain and epidural intolerance when continued injectate reaches a critical point, a threshold that is lower with shortened pedicles or congenital spinal stenosis. We believe a similar mechanism may explain the pain that patients sometimes experience after administration of large epidural volumes.

journal_name

Reg Anesth Pain Med

authors

Dickerson DM,Dai R,Scavone BM,McDade W

doi

10.1097/AAP.0000000000000493

subject

Has Abstract

pub_date

2016-11-01 00:00:00

pages

776-779

issue

6

eissn

1098-7339

issn

1532-8651

journal_volume

41

pub_type

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