[Skip to Content]
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
Purchase Options:
[Skip to Content Landing]
May 15, 1967

Peridural Effusion of Drugs Following Sympathetic Blockade

Author Affiliations

From the Department of Surgery, Section of Anesthesiology (Dr. Gay) and the Department of Radiology (Dr. Dobben), the University of Chicago and Chicago Lying-In Hospital, Chicago. Dr. Evans, temporarily with the University of Chicago Clinics, is now with the Department of Anesthesiology, Ehrling Bergquest Offutt Air Force Base Hospital, Omaha.

JAMA. 1967;200(7):573-578. doi:10.1001/jama.1967.03120200051006

Lumbar, paravertebral sympathetic block injections with a lidocaine and contrast solution resulted in significant peridural spread of contrast solution. Bilateral, extensive peridural effusion was demonstrated by multiple roentgenographic techniques. Preliminary studies indicate that agents used in stellate block procedures also extend to the peridural space. These studies cast doubt on the specificity of sympathetic blockade techniques. The findings offer an explanation for some of the sensory and motor phenomena resulting from sympathetic blocks. Neurolytic drugs used in large volumes for sympathetic blocks cannot be assumed to always produce their effects by acting within the area of injection. Sympathetic block procedures are useful for diagnosis and treatment; however, the volume of injected agent used in sympathetic block procedures should be limited, and increased vigilance for complications which may result should be practiced.

References 1 (pp 172-180), 2 (pp 119-121).
References 1(pp 172-180), 2(pp 119-121), 8, 9.
Moore, D.C.:  Regional Block , ed 3, Springfield, Ill: Charles C Thomas, Publisher, 1961, pp 99-117, 172-180.
Moore, D.C.:  Complications of Regional Anesthesia , Springfield, Ill: Charles C Thomas, Publisher, 1955, pp 53-54, 119-121.
Riekse, J.M.:  Terminal Obstetrical Anesthesia by Means of Lumbar Sympathetic Paravertebral Block ,  Amer J Obstet Gynec 78:411-414 ( (Aug) ) 1959.
Bromage, P.R.:  Spread of Analgesic Solutions in the Epidural Space and Their Site of Action: A Statistical Study ,  Brit J Anaesth 34:161-178 ( (March) ) 1962.Crossref
Bromage, P.R.:  Spinal Epidural Analgesia , Baltimore: Williams & Wilkins Co., 1954, p 17.
Dogliotti, A.M.:  Anesthesia , Chicago: S. B. Debour Publishers, 1939, pp 524-527.
Adriani, J.; Parmley, J.; and Ochsner, A.:  Fatalities and Complications After Attempts at Stellate Ganglion Block ,  Surgery 32:615-619 ( (Oct) ) 1952.
Adriani, J.:  Nerve Blocks , Springfield, Ill: Charles C Thomas, Publisher, 1954, p 59.
Bonica, J.J.:  The Management of Pain , Philadelphia: Lea & Febiger, 1953, pp 407-456.
Finer, B.:  Epidural Injection of Carbolic Acid in Incurable Cancer ,  Lancet 2:1179 ( (Nov 29) ) 1958.Crossref