Abstract

Michael W Best, Chaim Golfeiz and Manuel C Vallejo*

A 31-year-old prime at 40 weeks gestation requested epidural analgesia. An L3-L4 patient controlled epidural analgesia (PCEA) catheter was placed without complication. PCEA initial bolus consisted of 10 mL 0.0825% bupivacaine with fentanyl 100 μg, 8 mL/hr continuous infusion, 8 mL demand bolus, 8 minute lockout, and1-hour lockout of 24mL. Four hours later after pressing the PCEA button, she complained of constant, severe (10/10 verbal pain scale), sharp, bilateral subscapular back pain radiating to her left shoulder and arm. Pain intensified during respiration, relieved minimally sitting up (8/10), unable to lye supine or laterally.