Unexpected complication of attempted epidural anaesthesia: cauda equina syndrome

Cauda equina syndrome after regional anaesthesia is a serious and devastating complication. Its occurrence after epidural anaesthesia is rare. We report a 46-year-old male who received epidural anaesthesia for ureterorenoscopic lithotripsy and developed cauda equina syndrome postoperatively. Despite one failed attempt at entering the epidural space with an epidural needle resulting in dural puncture, an epidural catheter was inserted and 20 ml pH adjusted lignocaine 2% with 1:200,000 adrenaline injected via the catheter without untoward event. The possible causes of this complication are discussed. Fortunately, this patient recovered almost completely ten months later.