Accidental intradural injection during attempted epidural block -A case report-.

Area of Science:

• Anesthesiology
• Pain Management
• Neurosurgery

Background:

• Accidental subdural injection during epidural procedures is documented.
• Accidental intradural injection, a rarer complication, poses diagnostic challenges.

Purpose of the Study:

• To report a case of accidental intradural injection during an epidural block.
• To describe the diagnostic features and radiographic findings of this rare complication.

Main Methods:

• A diagnostic epidural injection was performed at the T9/10 interspace.
• C-arm guided X-ray imaging was utilized.
• Radiographic findings of contrast media distribution were reviewed.

Main Results:

• The patient experienced delayed block onset and irregular sensory dermatomes.
• Radiographic review revealed a dense, localized collection of radio-opaque contrast.
• These findings are characteristic of intradural injection, distinct from subdural patterns.

Conclusions:

• Accidental intradural injection can occur during epidural procedures.
• Characteristic radiographic findings are key to differentiating intradural from subdural injection.
• Prompt recognition is vital for appropriate management and patient safety.