The risks of overly effective postoperative epidural analgesia

Continuous epidural analgesia is frequently used to provide supplemental postoperative pain control. Epidural analgesia has the potential to mask the early symptoms that signal impending complications after even routine surgical procedures. We report a case of sciatic nerve palsy following epidural anesthesia after an uncomplicated leg length correction. Good epidural anesthesia may remove a patient's normal protective sensation, allowing pain and other signs of nerve compression from prolonged unchanged postoperative positioning to go unnoticed. This case highlights the need for heightened awareness of potential neurologic compromise in the setting of epidural analgesia. We recommend closely monitoring the patient's neurologic condition and frequently evaluating the patient's position in bed.