title: [Diagnosis of accidental subdural block].
abstract: Accidental subdural block occurred in a 47-year-old man who underwent gastrectomy under nitrous oxide-sevoflurane anesthesia combined with continuous epidural block. The development of subdural block was suspected from unexpectedly severe hypotension with small doses of mepivacaine during operation and was confirmed by a characteristic X-ray photograph after operation. The subdural block should be suspected from abnormal changes in vital signs and by careful observation of X-ray photographs, because it is not always easy to determine the presence of contrast media either in the subdural space or in the epidural space.
authors.affiliation: Department of Anesthesiology, Jichi Medical School, Tochigi.
authors.forename: K
authors.initials: K
authors.lastname: Saitoh
authors.forename: H
authors.initials: H
authors.lastname: Kasuda
authors.forename: Y
authors.initials: Y
authors.lastname: Hirabayashi
authors.forename: H
authors.initials: H
authors.lastname: Fukuda
authors.forename: H
authors.initials: H
authors.lastname: Mitsuhata
authors.forename: R
authors.initials: R
authors.lastname: Shimizu
mesh_terms: D000767:Anesthesia, Epidural / Q000009:adverse effects*; D002493:Central Nervous System Diseases / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007431:Intraoperative Complications / Q000175:diagnosis*; D008297:Male; D008619:Mepivacaine / Q000009:adverse effects; D008875:Middle Aged; D011859:Radiography; D013355:Subdural Space / Q000000981:diagnostic imaging
chemical_list: D008619:Mepivacaine