In Reply:--We thank Prof. Bromage for his comments on our recent publication. His suggestion that rotation of the liver, as caused by hyperlordosis, can lead to inferior vena cava (IVC) obstruction is a possibility, with the most probable site being just before entry into or in the lower part of the hepatic IVC sulcus. We agree with his view that epidural analgesia should be interrupted periodically to allow assessment of spinal cord function.
Georgios Amoiridis, MD; Neurologische Klinik, der Ruhr-Universitat, im St Josef Hospital, Gudrunstr. 56, 44791 Bochum, Federal Republic of Germany.
Johannes C. Wohrle, MD; Department of Neurology, University of Heidelberg, Klinikum Mannheim, 68135 Mannheim, Federal Republic of Germany.
Amoiridis G, Wohrle JC, Langkafel M, Maiwurm D, Przuntek H: Spinal cord infarction after surgery in a patient in the hyperlordotic position. ANESTHESIOLOGY 1996; 84:228-30.
Copyright 1996 by the American Society of Anesthesiologists, Inc.