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So I know the answer is to leave out the anesthetic but just curious what would happen. Coming from a PMR background I'm a little uncertain of the exact concentrations needed to cause issues. Hypothetically speaking, if you injected 2cc 0.25% Marcaine intrathecally at T4-5 or T5-6 would you shut down the patient's respiratory/cardiovascular system? I've got a end stage cancer patient that comes in for q3 month thoracic epidurals and his epidurogram always looks a little strange. Never had any issues though and reports excellent relief up until the next injection. I know, when in doubt leave out the anesthetic...