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Development of a subdural motor blockade

F Asato1, K Nakatani, Y Matayoshi

  • 1Department of Anaesthesia, Okinawa Chubu Hospital, Japan.

Anaesthesia
|January 1, 1993
PubMed
Summary
This summary is machine-generated.

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Anesthesia complication: subdural injection of local anesthetic caused unusual motor blockade in the upper extremities, not the lower. This rare subdural block presented with delayed onset and short duration.

Area of Science:

  • Anesthesiology
  • Neurology

Background:

  • Continuous lumbar epidural anesthesia is a common procedure.
  • Subdural injection is a rare complication of epidural anesthesia.

Observation:

  • A patient undergoing attempted continuous lumbar epidural anesthesia experienced an unusual subdural injection of local anesthetic.
  • This resulted in a gradual, complete motor blockade of the left upper extremity and incomplete blockade of the right upper extremity.
  • No motor blockade was observed in the lower extremities.

Findings:

  • The motor blockade exhibited characteristics of a subdural block: extensive spread, segmental distribution, delayed onset, and short duration.
  • Complete motor blockade lasted 10 minutes in the hand and 35 minutes in the arm.
  • Contrast medium spread in the subdural space correlated with the extent and degree of motor blockade.

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Implications:

  • This case highlights the importance of recognizing the signs and symptoms of subdural block.
  • Understanding the characteristic features can aid in prompt diagnosis and management of this rare complication.
  • Further research into the mechanisms and optimal treatment of subdural block is warranted.