Background and objectives: An epidural anesthetic was planned for a 75-year-old man scheduled for elective femoral-popliteal bypass grafting.
Methods: Severe and persistent back pain and posterior thigh muscle spasm abruptly began 10 minutes after epidural injection of mepivacaine.
Results: Signs of impending or evolving neurologic injury completely resolved shortly thereafter.
Conclusions: The worst case scenarios, epidural hematoma and unintentional epidural injection of an irritant, are discussed along with other differential diagnoses. The literature is reviewed to gain insight into this unusual clinical presentation.