Bupivacaine pleural effusion mimicking a hemothorax after a thoracoscopic microdiscectomy with epidural anesthesia.
Humans
Anesthesia, Epidural
/ adverse effects
Diskectomy
/ adverse effects
Bupivacaine
/ adverse effects
Intervertebral Disc Displacement
/ surgery
Pleural Effusion
/ diagnostic imaging
Hemothorax
/ etiology
Thoracic Surgery, Video-Assisted
/ methods
Diagnosis, Differential
Anesthetics, Local
/ adverse effects
Thoracic Vertebrae
/ surgery
Male
Pain, Postoperative
/ drug therapy
Middle Aged
Female
Bupivacaine
Epidural anesthesia
Hemothorax
Thoracic disc herniation
Thoracoscopic microdiscectomy
Journal
Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000
Informations de publication
Date de publication:
08 Jul 2024
08 Jul 2024
Historique:
received:
03
05
2024
accepted:
19
06
2024
medline:
8
7
2024
pubmed:
8
7
2024
entrez:
8
7
2024
Statut:
epublish
Résumé
Post-operative pain after video-assisted thoracoscopic surgery is often treated using thoracic epidural analgesics or thoracic paravertebral analgesics. This article describes a case where a thoracic disc herniation is treated with a thoracoscopic microdiscectomy with post-operative thoracic epidural analgesics. The patient developed a bupivacaine pleural effusion which mimicked a hemothorax on computed tomography (CT). The presence of bupivacaine in the pleural effusion was confirmed using a high performance liquid chromatography method. The patient underwent a re-exploration to relieve the pleural effusion. The patient showed a long-term recovery similar to what can be expected from an uncomplicated thoracoscopic microdiscectomy. A pleural effusion may occur when thoracic epidural analgesics are used in patents with a corridor between the pleural cavity and epidural space.
Identifiants
pubmed: 38976059
doi: 10.1007/s00701-024-06173-0
pii: 10.1007/s00701-024-06173-0
doi:
Substances chimiques
Bupivacaine
Y8335394RO
Anesthetics, Local
0
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
284Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.
Références
DeBiasi EM, Feller-Kopman D (2021) Anatomy and applied physiology of the pleural space. Clin Chest Med 42(4):567–576
doi: 10.1016/j.ccm.2021.08.005
pubmed: 34774165
Homma T, Doki Y, Yamamoto Y, Ojima T, Shimada Y, Kitamura N, Yoshimura N (2018) Risk factors of neuropathic pain after thoracic surgery. J Thorac Dis 10(5):2898
doi: 10.21037/jtd.2018.05.25
pubmed: 29997955
pmcid: 6006121
Kozar S, Marić S, Novak Jankovič V (2011) Development of post-thoracotomy pain syndrome in patients undergoing lung surgery–comparison of thoracic paravertebral and epidural analgesia. Period Biol 113(2):229–233
Peek GJ, Morcos S, Cooper G (2000) The pleural cavity. BMJ 320(7245):1318–1321
doi: 10.1136/bmj.320.7245.1318
pubmed: 10807628
pmcid: 1127313
Thomas SP, Gerson JI, Strong G (1992) Analysis of human epidural pressures. Reg Anesth Pain Med 17(4):212–215
Venuta F, Diso D, Anile M, Rendina EA, Onorati I (2017) Chest tubes: generalities. Thorac Cardiovasc Surg 27(1):1–5
Yamazaki S, Koike S, Eguchi T, Matsuoka S, Takeda T, Miura K, Hamanaka K, Shimizu K (2022) Preemptive intercostal nerve block as an alternative to epidural analgesia. Ann Thorac Surg 114(1):257–264
doi: 10.1016/j.athoracsur.2021.07.019
pubmed: 34389301