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Successive Failures of Epidural Anesthesia After Repeated Extracorporeal Shock Wave Lithotripsy
  1. Christopher J. Lander, MD*,
  2. Gregg A. Korbon, MD,
  3. Brian R. Williamson, MD and
  4. Wayne S. Cail, MD§
  1. From the Departments of Anesthesiology and Radiology, University of Virginia Medical Center, Charlottesville, Virginia
  2. *Resident in Anesthesiology.
  3. Staff Anesthesiologist, Martha Jefferson Hospital, Charlottesville, VA.
  4. Associate Professor of Radiology.
  5. §Associate Professor of Radiology and Neurology.


Inadequate anesthesia after acutely repeated continuous iumbar epidural anesthesia (CLEA) and extracorporeal shockwave lithotripsy (ESWL) has been described. Although initial investigations have shown ESWL to have little effect on adjacent tissues, with the exception of pulmonary parenchyma, preliminary studies in animals have displayed pathology in the epidural space after repeated CLEA for ESWL.2,3,4,5 This article describes a patient who after two successful CLEAs for repeated ESWL displayed incomplete anesthesia with two subsequent epidural anesthetics more than 4 months apart.

  • Anesthetic techniques
  • epidural surgery
  • urological
  • extracorporeal shock wave lithotripsy

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