A lumboperitoneal shunt facilitates dynamic flow of cerebrospinal fluid into the peritoneum. Consequently, neuraxial technique placement in the parturient with a lumboperitoneal shunt can result in unexpected levels of blockade. We present the case of a parturient with a lumboperitoneal shunt who experienced symptoms consistent with high blockade after epidural administration of 450 mg chloroprocaine. This report emphasizes potential mechanisms for high neuraxial blockade and strategies to decrease risks in this unique patient population.
From the Department of *Anesthesiology and Critical Care
†Neurosurgery, Tufts Medical Center, Boston, Massachusetts.
Accepted for publication December 6, 2018.
The authors declare no conflicts of interest.
Address correspondence to Robert R. Hall III, BS, Departments of Anesthesiology and Critical Care, Tufts Medical Center, 800 Washington St, Ziskind 6, Boston, MA 02111. Address e-mail to firstname.lastname@example.org.