Abstract:

Objective To explore the mechanism, adverse effects, and management of Horner's syndrome (HS) following lumbar epidural blocking. Methods The clinical data of 3 parturients under caesarean section with HS after lumbar epidural blocking were analyzed. Results HS symptoms, such as lateral ptosis and miosis, were noted in 3 parturients 40 min after lumbar epidural blocking. The hemodynamic parameters of all 3 parturients were stable, and mild dyspnea occurred in one. The Apgar scores of neonates were normal. The symptoms spontaneously regressed 2 h later without any intervention. Conclusion The plausible mechanism for the development of HS associated with epidural blocking is the cephalad spread of local anesthesia, which may result from the decreased capacity of epidural space and increased intra-abdominal pressure of pregnant women. Sympathetic fiber hypersensitivity may also contribute to HS. HS as a complication of lumbar epidural blocking is usually benign and spontaneously reversible. These patients with HS should be monitored closely for autonomic complications.

Key words: epidural blocking, Horner's syndrome, caesarean section