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Severe Lumbar Back Pain Following Epidural Injection of Local Anesthetic for Epidural Anesthesia: Case Report and Literature Review
  1. Richard A. Beers, M.D.,
  2. P. Sebastian Thomas, M.D.,
  3. Robert J. Martin, M.D. and
  4. Reza Gorji, M.D.
  1. Departments of Anesthesiology and Neurosurgery, State University of New York Health Science Center, Syracuse, New York
  1. Reprint requests: Dr. R. Beers, Department of Anesthesiology, State University of New York Health Science Center, 750 East Adams Street, Syracuse, NY 13210.


Background and Objectives An epidural anesthetic was planned for a 75-year-old man scheduled for elective femoral-popliteal bypass grafting.

Methods Severe and persistent back pain and posterior thigh muscle spasm abruptly began 10 minutes after epidural injection of mepivacaine.

Results Signs of impending or evolving neurologic injury completely resolved shortly thereafter.

Conclusions The worst case scenarios, epidural hematoma and unintentional epidural injection of an irritant, are discussed along with other differential diagnoses. The literature is reviewed to gain insight into this unusual clinical presentation.

  • anesthetic techniques
  • epidural anesthesia
  • complications
  • back pain

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