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Subdural block--from a spinal? A case report
1Department of Anaesthesia, Changi General Hospital, 2 Simei Street 3, Singapore 529889.
Introduction:
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.
Clinical Picture:
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.
Treatment/Outcome:
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.
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