Intraoperative hypotension due to unrecognized bleeding from a continuous spinal catheter site

We recently cared for a patient who had a rare complication from a continuous spinal catheter: extensive bleeding around the catheter insertion site. This complication went unrecognized intraoperatively because the bleeding was hidden from view. The possible etiologies for this bleeding are discussed, as well as methods to recognize this complication before significant bleeding occurs.