Thoracic Epidural Cephalad Spread — FRCA Final MCQ

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HardCardiothoracic AnaesthesiaThoracic Epidural Cephalad SpreadFRCA Final

Thoracic epidural at T5-T6: patient develops Horner syndrome and unilateral hand weakness. Explanation?

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Correct answer: E — Excessive cephalad spread to C8-T1

Horner + hand weakness from thoracic epidural = excessive cephalad spread to C8-T1 (hand intrinsics T1, sympathetic chain T1-T2). Reduce infusion rate/concentration, monitor for respiratory compromise (phrenic C3-5), reassess block height.

Reference: RCOA – 2023 – Thoracic epidural complications