To make long story short:
56 year old with axial LBP worse in AM, will standing and with extension. MRI with diffuse "severe disc degeneration. Has bilateral L3 to sacrum MBB with 0.5% bupivacaine and has > 80% relief for what he describes as a day. Confirmatory block done with 2% lidocaine and reports no relief. Of note, due to insurance limitations procedure done in hospital. Anesthesiologist snows patient with propofol and when I go to examine him he is out cold. As it happens he is discharged via wheelchair 2 hours latter and I do not get to see him until today when he reports no relief at all on the day of the procedure.
Aside for initial procedure being a false positive, is it reasonable to postulate that his PACU stay outlived the LA duration or am I just dreaming?
56 year old with axial LBP worse in AM, will standing and with extension. MRI with diffuse "severe disc degeneration. Has bilateral L3 to sacrum MBB with 0.5% bupivacaine and has > 80% relief for what he describes as a day. Confirmatory block done with 2% lidocaine and reports no relief. Of note, due to insurance limitations procedure done in hospital. Anesthesiologist snows patient with propofol and when I go to examine him he is out cold. As it happens he is discharged via wheelchair 2 hours latter and I do not get to see him until today when he reports no relief at all on the day of the procedure.
Aside for initial procedure being a false positive, is it reasonable to postulate that his PACU stay outlived the LA duration or am I just dreaming?