• Reg Anesth Pain Med · May 2005

    Case Reports

    Rapid onset of massive subdural anesthesia.

    • John H Wills.
    • Department of Anesthesia and Critical Care Medicine, University of New Mexico, Albuquerque, NM 87131-0001, USA. jwills@salud.unm.edu
    • Reg Anesth Pain Med. 2005 May 1; 30 (3): 299-302.

    ObjectiveThis case report describes the accidental placement of a lumbar labor epidural catheter into the subdural space resulting in the rapid onset of massive subdural anesthesia.Case ReportA single-orifice open-ended catheter was accidentally placed in the lumbar subdural space. After a test dose of 3 mL 1.5% lidocaine with 15 microg of epinephrine and 2 minutes after a bolus of 5 mL of 0.25% bupivacaine, there was a rapid onset of massive subdural anesthesia with a loss of consciousness, respiratory arrest, and absent pulses. The subdural catheter placement was confirmed by injection of a contrast agent under fluoroscopy.ConclusionMassive subdural anesthesia is a complication of epidural catheter placement and may have a rapid onset causing a loss of consciousness, respiratory arrest, and absent pulses.

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