Which anesthetic technique should be used for cesarean section in the case of Horner ’s syndrome associated with epidural analgesia in labor?

Recently, Chambers and Bhatia published a very good review of Horner ’s syndrome (HS) following obstetric neuraxial blockade.1 As explained by the authors, the main mechanism of HS in pregnant patients receiving epidural analgesia is the cephalic spread of local anesthetic leading to block of the sympathetic chain from C8 to T1. These thoracic levels correspond to a potentially dangerous situation in the case of complete sensory and motor anesthesia. Consequently, many anesthesiologists who are not fully familiar with this uncommon syndrome may be concerned about maintaining epidural block and might decide to stop or to temporarily decrease the amount of loca l anesthetic given until the complete resolution of the HS.
Source: International Journal of Obstetric Anesthesia - Category: Anesthesiology Authors: Tags: Correspondence Source Type: research