Horner''s syndrome after intrapleural anesthesia with bupivacaine for post-herpetic neuralgia

We observed the development of Horner's syndrome 25 min after the intrapleural administration of 30 cc of 0.5% bupivacaine to a patient with post-herpetic neuralgia in the thoracic region. The patient reported immediate relief of pain. There was no change in blood pressure or pulse rate, and no discernible level of anesthesia to pinprick was detected.