Accidental Bilateral Sciatic Nerve Block After Gynecologic Procedure

Abstract

Background: Local anesthesia techniques for minor obstetric and gynecologic procedures are routinely performed around the world, as these techniques are relatively easy to learn and perform. The low complication rate of these techniques is commendable, given the busy clinical environment in which obstetricians and gynecologists practice. However, complications do occur. Case: A 48-year-old female was scheduled for ambulatory surgery for a rectocele with cervical amputation under general anesthesia. Perioperatively, the surgeon performed pudendal and paracervical blockades along with local anesthetic infiltration of the sacrouterine ligaments. In the postoperative period, the patient presented with bilateral sciatic nerve blockage, which was caused by an unintended spread of the local anesthetic. She was admitted for further observation. Results: This patient's sensory and motor deficit was resolved spontaneously by the next morning. Conclusions: Awareness regarding possible complications, prevention, and prompt diagnosis are the keys to safe use of regional anesthesia and patients' early ambulation. ( J GYNECOL SURG 32:133)