%0 Case Reports
%T Bupivacaine pleural effusion mimicking a hemothorax after a thoracoscopic microdiscectomy with epidural anesthesia.
%A Dorsthorst-Maas MT
%A Vissers YLJ
%A Grupa NM
%A Deben DS
%A Boselie TFM
%J Acta Neurochir (Wien)
%V 166
%N 1
%D 2024 Jul 8
%M 38976059
%F 2.816
%R 10.1007/s00701-024-06173-0
%X <B>OBJECTIVE: </B>Post-operative pain after video-assisted thoracoscopic surgery is often treated using thoracic epidural analgesics or thoracic paravertebral analgesics. This article describes a case where a thoracic disc herniation is treated with a thoracoscopic microdiscectomy with post-operative thoracic epidural analgesics. The patient developed a bupivacaine pleural effusion which mimicked a hemothorax on computed tomography (CT).<BR><B>METHODS: </B>The presence of bupivacaine in the pleural effusion was confirmed using a high performance liquid chromatography method.<BR><B>RESULTS: </B>The patient underwent a re-exploration to relieve the pleural effusion. The patient showed a long-term recovery similar to what can be expected from an uncomplicated thoracoscopic microdiscectomy.<BR><B>CONCLUSIONS: </B>A pleural effusion may occur when thoracic epidural analgesics are used in patents with a corridor between the pleural cavity and epidural space.