Korean J Anesthesiol.  1994 Jun;27(6):655-659. 10.4097/kjae.1994.27.6.655.

Inadvertent subdural block in epidural anesthesia: A case confirmed by radiographic contrast material

• Lee SM
• Park EK
• Kim HR
• Cho MW
• Han BK
• Suh DC

• KMID: 2298876
• DOI: http://doi.org/10.4097/kjae.1994.27.6.655

Abstract

Malposition of catheter in the subdural space is a possible complication during attempted epidural anesthesia. We report here an inadvertent subdural block confirmed by the radiographic contrast materiaL Epidural anesthesia was planned for a full-term gravida and epidural catheter was inserted about 3 cm cranially at the level of L1-2. After injection of 19.5 ml local anesthetic, blood pressure was 70/50 mmHg. Fluid was rapidly infused and intravenous ephedrine 10 mg was given. After then, vital signs were well maintained and twin babies were delivered without events. Twentyfive minutes later, she complained chest tightness and became tachypneic. Ketamine 50 mg was given and endotracheal intubation was performed with ease. She obeyed command, but could not open her eyes for some duration. Self respiration returned after 110 minutes and minute ventilation was 6 liter/minute at that time. 160 minutes later, extubation was done and radiological examination was performed using contrast materiaL The cathter tip was positioned in anterior subdural space at T12 level.

Keyword

Epidural anesthesia; Subdural block; Radiologic examination

MeSH Terms

Anesthesia, Epidural*
Blood Pressure
Catheters
Ephedrine
Humans
Intubation, Intratracheal
Ketamine
Respiration
Subdural Space
Thorax
Twins
Ventilation
Vital Signs
Ephedrine
Ketamine