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Case report
Rapid Onset of Massive Subdural Anesthesia
  1. John H. Wills, F.A.N.Z.C.A.
  1. From the Department of Anesthesia and Critical Care Medicine, University of New Mexico, Albuquerque, NM.
  1. Reprint requests: John Wills, F.A.N.Z.C.A., Department of Anesthesiology and CCM, MSC 11-6120, 1 University of New Mexico, Albuquerque, NM 87131-0001. E-mail: jwills{at}salud.unm.edu

Abstract

Objective This 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 Report A 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 μg 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.

Conclusion Massive 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.

  • Anesthetic techniques
  • Epidural
  • Extradural
  • Complications
  • Subdural injection
  • Respiratory arrest
  • Hypotension

https://doi.org/10.1016/j.rapm.2005.01.002

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