Subdural block--from a spinal? A case report.
BACKGROUND
Multicompartmental blocks are commonly described in epidurals but not spinals. We describe a case of subarachnoid block performed in an obese patient which resulted in a clinical presentation resembling that of a subdural block.


METHODS
A 29-year-old woman, scheduled for saucerisation of thigh carbuncle, was administered 2.1 mL of hyperbaric bupivacaine. The spinal resulted in a late onset of sensory block that extended to the neck and upper limbs. There was no sympathetic or motor blockade.


RESULTS
The block receded spontaneously without causing any cardiovascular or respiratory compromise.


CONCLUSIONS
The diagnosis of subdural block must be considered in patients with unusual presentations after a spinal anaesthetic. Factors affecting spread of hyperbaric bupivacaine are also highlighted.
Chan
S Y
SY
Department of Anaesthesia, Changi General Hospital, 2 Simei Street 3, Singapore 529889.
Ong
E L
EL
D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000494:pharmacology*; D002045:Bupivacaine / Q000494:pharmacology*; D005260:Female; D006801:Humans; D009407:Nerve Block / Q000009:adverse effects*; D012075:Remission, Spontaneous; D013346:Subarachnoid Space / Q000187:drug effects*; D013355:Subdural Space / Q000187:drug effects*
D000779:Anesthetics, Local; D002045:Bupivacaine