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Unintentional combined epidural and subdural block. Case report
S Chauhan1, A Gaur, M Tripathi
1Department of Anaesthesiology and Critical Care Medicine, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Background And Objectives:
Unintentional subdural block, while attempting an epidural anesthetic, is a rare but known complication. The authors describe a radiologically confirmed case of an unintentional combined epidural and subdural block while attempting to perform an epidural block for transurethral resection of prostate in a middle-aged man.
Methods:
Loss of resistance to air injection was used for identifying the epidural space prior to catheter placement. Following the epidural injection of 20 mL of a 1.5% lidocaine and 0.5% bupivacaine mixture, the patient developed rapid, intense, prolonged, and extensive bilateral motor block up to C2 level.
Results:
The patient had aphonia and respiratory paralysis requiring endotracheal intubation and controlled ventilation for 3 hours.
Conclusions:
Postoperative radiologic examination revealed the spread of the dye in both epidural and subdural spaces, causing the extensive sensory and motor block.