John H Wills1. 1. Department of Anesthesia and Critical Care Medicine, University of New Mexico, Albuquerque, NM 87131-0001, USA. jwills@salud.unm.edu
Abstract
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. CASE REPORT: 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. CONCLUSION: 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.
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. CASE REPORT: 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. CONCLUSION: 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.