Ipsilateral Horner Syndrome Induced by Epidural Bolus During Conversion from Labor Analgesia to Surgical Anesthesia

Document Type

Conference Proceeding

Publication Date

10-18-2026

Abstract

27 year old G1P0 39w3d with a hx of gHTN presented for induction of labor, received labor epidural that was working sufficiently, and subsequently failed induction. Epidural bolused with 15cc’s of lidocaine 2%. Following delivery, the patient appeared ipsilaterally skin flushing, miosis and ptosis. This case highlights the physiologic basis of sympathetic blockade during epidural dosing, the importance of recognizing benign neuraxial-associated Horner syndrome, and the need to differentiate from concerning etiologies such as subdural spread, total spinal anesthesia, or carotid artery pathology. Awareness of this phenomenon can prevent unnecessary diagnostic evaluation and alleviate patient anxiety during the peripartum period.

Comments

American Society of Anesthesiologists, The Anesthesiology Meeting, October 16-20, 2026, San Diego, CA

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