Unintended subdural injection: a complication of epidural anesthesia--a case report.
Epidural anesthesia is practiced in virtually every clinical setting. Its safety and versatility have supported increasing use for more and varied therapies. In a healthy patient in whom near-complete left hemiparesis developed following a routine continuous epidural anesthetic for labor, subdural deposit of the local anesthetic was suspected. The following case and discussion may help illustrate the mechanism behind this complication and how it can be detected, treated, and, possibly, avoided.
Kalil
Adrian
A
Kaiser Foundation Hospitals, Portland, Ore, USA. adriankalil@earthlink.net
D000759:Adjuvants, Anesthesia / Q000009:adverse effects; D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects* / Q000379:methods; D000773:Anesthesia, Obstetrical / Q000009:adverse effects* / Q000379:methods; D000779:Anesthetics, Local / Q000009:adverse effects; D002045:Bupivacaine / Q000009:adverse effects; D016903:Drug Monitoring; D005260:Female; D005283:Fentanyl / Q000009:adverse effects; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D008508:Medication Errors / Q000009:adverse effects; D008578:Meninges / Q000033:anatomy & histology; D016343:Monitoring, Intraoperative; D010291:Paresis / Q000139:chemically induced*; D016528:Postanesthesia Nursing; D011247:Pregnancy; D020127:Recovery of Function; D013355:Subdural Space / Q000033:anatomy & histology / Q000187:drug effects*
D000759:Adjuvants, Anesthesia; D000779:Anesthetics, Local; D005283:Fentanyl; D002045:Bupivacaine