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[Subdural block which appeared 21 days after beginning continuous epidural block]
Hiroto Goto1, Matsuko Matsunaga, Kazuo Higa
1Department of Anesthesiology, Fukuoka Teishin Hospital, Fukuoka 810-8798.
Masui. the Japanese Journal of Anesthesiology
|April 28, 2010
Summary
Subdural block, a rare complication of epidural anesthesia, can occur even with proper initial catheter placement. This case highlights the potential for catheter migration leading to unexpected neurological symptoms like Horner
Area of Science:
- Anesthesiology
- Neurology
Background:
- Epidural analgesia is a common technique for pain management.
- Acute herpetic pain can be debilitating and may require continuous epidural infusion.
- Proper placement of the epidural catheter is crucial to avoid complications.
Observation:
- A 68-year-old woman received continuous epidural infusion for herpetic pain.
- Initial placement at T10-11 interspace and negative aspiration tests were confirmed.
- On day 21, after an injection, the patient developed Horner's syndrome and limb weakness.
Findings:
- The observed symptoms suggested a subdural block, a rare complication.
- Catheter migration into the subdural space was suspected as the cause.
- This occurred despite initial correct placement in the epidural space.
Implications:
- Subdural block can occur unpredictably, even with meticulous technique.
- Continuous monitoring for neurological changes is essential during prolonged epidural therapy.
- This case underscores the importance of recognizing and managing rare epidural complications.
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