Canadian Journal of Anesthesia, Vol 28, 82-85, Copyright © 1981 by Canadian Anesthesiologists' Society

Horner's Syndrome during Epidural Anaesthesia for Elective Caesarean Section

¹ Harvard Medical School; Boston Hospital for Women, 221 Longwood Avenue, Boston, Massachusetts 02115, USA

Twenty ml of three per cent chloroprocaine solution was injected into the lumbar epidural space of a parturient for anaesthesia for elective caesarean section. Ten minutes after injection of the anaesthetic, the patient developed Horner's syndrome on the left side. The anaesthetic level was C7 on the affected side. Thirty minutes after the bolus dose of chloroprocaine the signs disappeared, at which time the patient received a reinforcing dose of 10 ml of chloroprocaine three per cent. The Homer's complex reappeared in eight minutes and persisted for 20 minutes.

While Horner's syndrome is not uncommon in women in labour receiving lumbar epidural anaesthesia, it is virtually unknown in patients who are not in labour. The mechanism for the appearance of the syndrome in this case is unclear. The most likely explanation is that only a small amount of local anaesthetic was necessary to produce the syndrome and the subsequent bolus of anaesthetic followed pathways opened by the original dose, since a much smaller amount of anaesthetic was necessary to reproduce the syndrome.

Note:

Present address: Dept. of Anesthesiology, University Hospital, State University of N.Y. at Stony Brook, Stony Brook, N.Y. 11794.

Key Words: ANAESTHETIC TECHNIQUES, epidural • OBSTETRICAL ANAESTHESIA, complications, Horner's syndrome