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Published on: October 25, 2015
Inadvertent Subdural Catheter Placement: A Rare Complication in Obstetric Anesthesia
Abdalhai Alshoubi1, Danny Newhide2
1Clinical Anesthesiology and Critical Care Medicine, St. Joseph's Medical Center, Stockton, USA.
Abstract:
Epidural neuraxial analgesia is a standard procedure for pain control during labor and delivery. One rare complication is accidental epidural catheter placement in the subdural space, a potential space between the arachnoid and dura membranes. The incidence of the subdural blockade during neuraxial block is unknown. The subdural block suspicion arises when the clinical signs and symptoms do not fit epidural or subarachnoid local anesthetic injection. The clinical picture includes delayed or gradual onset, extensive sensory block with minimal motor block, hypotension more than an epidural neuraxial block, and less than spinal neuraxial block, and it can rarely track intracranially and causes dyspnea and loss of consciousness. In this article, we report a case of inadvertent subdural catheter placement that was diagnosed clinically with unexpectedly high block involving the upper extremities. No radiological confirmation was used for the diagnosis.
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