Sudden onset of subarachnoid block after subdural catheterization: a case of arachnoid rupture?
We describe a patient who received an apparently uneventful extradural block in labour but developed rapid extension of neural block within minutes of receiving her first incremental dose 2 h later. Computed contrast tomography revealed radio-opaque dye within both the subdural and subarachnoid spaces, but none within the extradural space. This case report demonstrates that subdural spread of low-dose local anaesthetics is not always clinically distinguishable from extradural analgesia and that the arachnoid membrane may subsequently perforate with potentially serious consequences.
Elliott
D W
DW
Department of Anaesthesia and Intensive Care, Flinders Medical Centre, South Australia.
Voyvodic
F
F
Brownridge
P
P
D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects*; D016362:Analgesia, Obstetrical / Q000009:adverse effects*; D001099:Arachnoid / Q000293:injuries*; D002404:Catheterization / Q000009:adverse effects*; D005260:Female; D006801:Humans; D009407:Nerve Block; D011247:Pregnancy; D012421:Rupture; D013346:Subarachnoid Space / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed