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Horner’s Syndrome and Upper Extremity Weakness After Quadratus Lumborum Block for Postcesarean Section Analgesia

A Case Report

Anderson, Michael, MD, MS*; Chernishof, Vasili, MD*; Norris, Mark C., MD

doi: 10.1213/XAA.0000000000000920
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A healthy, 34-year-old primigravida at 41 weeks gestational age presented for cesarean delivery due to a category 2 fetal heart tracing remote from delivery. After completion of the surgery under epidural anesthesia, bilateral quadratus lumborum blocks were performed for postoperative pain. Approximately 4 hours later, the patient developed left-sided arm weakness, left miosis, and ptosis. These symptoms resolved within 24 hours. Considering the time course of her symptoms, we believe that the quadratus lumborum block was the likely culprit.

From the *Department of Anesthesiology, Boston University Medical Center, Boston, Massachusetts

Boston University School of Medicine, Boston, Massachusetts.

Accepted for publication September 4, 2018.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Mark C. Norris, MD, Department of Anesthesiology, Boston Medical Center, 88 E. Newton St, Boston, MA 02118. Address e-mail to mark.norris@bmc.org.

© 2019 International Anesthesia Research Society
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