Rapid onset of massive subdural anesthesia.
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.


METHODS
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 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.


CONCLUSIONS
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.
Wills
John H
JH
Department of Anesthesia and Critical Care Medicine, University of New Mexico, Albuquerque, NM 87131-0001, USA. jwills@salud.unm.edu
D000328:Adult; D015360:Analgesia, Epidural; D016362:Analgesia, Obstetrical; D000779:Anesthetics, Local / Q000008:administration & dosage; D002585:Cesarean Section; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced; D006801:Humans; D008012:Lidocaine / Q000008:administration & dosage; D019300:Medical Errors; D011247:Pregnancy; D011674:Pulse; D013355:Subdural Space; D014474:Unconsciousness / Q000139:chemically induced
D000779:Anesthetics, Local; D008012:Lidocaine