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Background and Aims Epidural analgesia is widely used, providing effective pain control, facilitating mobilization and recovery of gut function. Although often safe, we present the case of a rare, potentially hazardous complication of this technique.

Methods We report the case of a 75 year-old male who underwent right hemicolectomy under combined anesthesia. Epidural space was identified at T9-T10 level using air loss of resistance (LOR) technique and was subsequently tested using 2% lidocaine after negative catheter aspiration. Catheter placement and testing were unremarkable. During surgery, several 0.2% ropivacaine boluses were administred. Afterwards the patient reported controlled pain, without paresthesia or motor block. A perfusion of 0.15% ropivacaine and sufentanil was started and he was later transferred to the ward.

Results Six hours after transfer, there was a new onset of lower limb paralysis, without hemodynamic instability. Epidural perfusion was discontinued and soon after the