Lumbosacral plexopathy following regional paracervical block anaesthesia.

ABSTRACT

We report a 35 year old lady who developed lumbosacral plexopathy immediately following regional paracervical block anaesthesia for medical termination of pregnancy. There was only partial recovery at one year. The neurological deficit and its mechanisms are discussed.

ABSTRACT

PIP A case of permanent injury to the nerves of the lumbosacral plexus as a result of regional paracervical block anesthesia before dilatation and curettage for abortion at 8 weeks' gestation is presented. The woman, aged 35, para 2, was given xylocaine. During injection she complained of pain in the gluteal muscle and left leg. The pain intensified and numbness, tingling and paraesthesia developed over 24 hours. The pain radiated to the L5-S1 distribution on the left when she raised her lower limb. She had difficulty moving her lower leg, and by 9 days later had hypotonia and foot drop, with absent ankle reflexes. While she gradually improved over 2 months, her condition stabilized with hypoesthesia of the left foot, foot drop and absent left ankle jerk reflex. The cause of this neuropathy is unknown, but thought to be either hematoma, direct trauma, infection. Thorough knowledge of nerve structure in the area is essential when giving paracervical block.