Abstract
In the morning a healthy 40 years old female had a successful spinal anesthetic with bupivacaine 1% 10 mg for hemorrhoidectomy followed by a second injection at midnight for severe pain. The second traumatic injection caused a conus medullaris/cauda equina lesion discovered by MRI 45 days later. The contribution of hyperbaric bupivacaine dosage and pencil point needle is discussed.
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