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Strange epidural side effect

Posted Sep 28 2008 11:24am 1 Comment


Not my patient.........

Recently, we had a patient getting an epidural for pain management of her labor. Upon insertion of the epidural catheter, she experienced severe bilateral shoulder pain. Nothing relieved the shoulder pain. Bolusing the standard mixture of local/narcotic combination of drugs into her epidural space gave her good relief of the contraction pain. However, she still had severe bilateral shoulder pain. The epidural catheter was removed, and the pain went away.

The anesthesiologist was perplexed as to what exactly could be causing the correlation between the epidural catheter and the shoulder pain.

Epidurals are placed low in the back, so the nerve roots near the epidural placement would not alter the sensation above the insertion site, much less travel as far as both shoulders. (It is common, however, to feel a sharp zing down one leg or the other, as the catheter is threaded into the epidural space.)

I couldn't find any studies or sites that could explain this patient's extreme shoulder pain relating to the epidural insertion.

Any thoughts? Ideas?
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I recently had a baby and experienced the same pain.  The epidural catheter was not removed until after delivery (nearly 12 hours later).  The pain between my shoulders went away, but a severe pain remained in my right shoulder.  I was told it was gas.  After a week my doctor determined that it was not gas and sent me to physical therapy.  The pain is getting better, but  now travels from my right to my left shoulder.  I am also experiencing numbness in the upper part of my right arm.  The shoulder pain was far worse than anything I have ever experienced in my life - my c-section, included.  If anyone has any answers please let me know.  I am afraid to have anymore children due to this. 
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