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Coexisting harlequin and Horner syndromes after high thoracic paravertebral anaesthesia.

Abstract
A patient undergoing left mastectomy and immediate latissimus dorsi breast reconstruction under combined paravertebral block and general anaesthesia developed transient, well-demarcated, right-sided hemifacial erythema and sweating, and left-sided Horner syndrome postoperatively. This "harlequin" appearance occurs because of a normal or excessive vasodilatory, thermoregulatory response to heat or emotion mediated by an intact sympathetic pathway on the erythematous side, together with relative pallor of the pharmacologically blocked side.
AuthorsC L Burlacu, D J Buggy
JournalBritish journal of anaesthesia (Br J Anaesth) Vol. 95 Issue 6 Pg. 822-4 (Dec 2005) ISSN: 0007-0912 [Print] England
PMID16227336 (Publication Type: Case Reports, Journal Article)
Topics
  • Anesthesia, General (adverse effects)
  • Erythema (etiology)
  • Facial Dermatoses (etiology)
  • Female
  • Flushing (etiology)
  • Horner Syndrome (etiology)
  • Humans
  • Mammaplasty
  • Mastectomy
  • Middle Aged
  • Nerve Block (adverse effects)
  • Postoperative Complications

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