BRACHIAL PLEXUS PALSY AND HOARSENESS OF THE VOICE DURING LUMBAR EPIDURAL ANALGESIA FOR LABOR AND DELIVERY: A CAUTIONARY TALE

The lumbar epidural analgesia is one of better ways of controlling pain during labor but it still can be followed with complications and unintentional side effects. Neurologic complications of epidural analgesia are rare. We present two cases of healthy women where epidural analgesia was induced during active labor. Repeated intermittent epidural doses of local anesthetics and the left lateral decubitus position of the patients induced the cephalic spread of the anesthetic drug along the epidural space with the appearance of unilateral brachial plexus palsy and hoarseness of the voice. These side effects disappeared spontaneously but caused anxiety in the patients and in all medical staff. Elevated control by anesthetists is necessary in case of epidural analgesia during active labor to avoid risky complications like the high sympathetic block.