Total spinal anesthesia: a rare complication of intrathoracic intercostal nerve block

Ann Thorac Surg. 1976 Sep;22(3):289-92. doi: 10.1016/s0003-4975(10)64919-3.


Total spinal anesthesia following intrathoracic intercostal nerve blocks with bupivacaine performed for postoperative pain relief during thoracotomy is described. Possible mechanisms for this complication include: (1) inadvertent placement of the needle through an intervertebral foramen, (2) puncture of a long dural cuff, and (3) intraneural injection with central spread. Recognition of this potential complication is important, and facilities for proper support must be available.

Publication types

  • Case Reports

MeSH terms

  • Bupivacaine / adverse effects
  • Female
  • Humans
  • Injections / adverse effects
  • Intercostal Nerves*
  • Middle Aged
  • Nerve Block / adverse effects*
  • Pain Management
  • Paralysis / etiology*
  • Postoperative Complications / therapy
  • Spinal Cord Injuries / etiology*
  • Thoracic Nerves*
  • Thoracic Surgery
  • Thorax / surgery


  • Bupivacaine