Professional paper

BRACHIAL PLEXUS PALSY AND HOARSENESS OF THE VOICE DURING LUMBAR EPIDURAL ANALGESIA FOR LABOR AND DELIVERY: A CAUTIONARY TALE

Lada Kalagac orcid.org/0000-0001-8645-2128 ; Department of Anesthesia and ICU General Hospital Pula , Pula, Croatia
Adriana Maretić ; Department of Anesthesia and ICU, General Hospital Pula , Pula, Croatia
Dragan Belci ; Department of obstetrics and gynecology General Hospital Pula , Pula, Croatia
Milan Prenc ; Department of obstetrics and gynecology General Hospital Pula , Pula, Croatia

Abstract

The lumbar epidural analgesia is one of better ways of controlling pain during labor but it still can be followed
with complications and unintentional side effects. Neurologic complications of epidural analgesia are rare.
We present two cases of healthy women where epidural analgesia was induced during active labor. Repeated intermittent
epidural doses of local anesthetics and the left lateral decubitus position of the patients induced the cephalic spread of the
anesthetic drug along the epidural space with the appearance of unilateral brachial plexus palsy and hoarseness of the voice.
These side effects disappeared spontaneously but caused anxiety in the patients and in all medical staff. Elevated control by
anesthetists is necessary in case of epidural analgesia during active labor to avoid risky complications like the high sympathetic
block.

Keywords

epidural analgesia in obstetrics; brachial plexus palsy; voice hoarseness; sympathetic block

Hrčak ID:

85617

URI

https://hrcak.srce.hr/85617

Publication date:

30.12.2011.

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