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A continuous subdural block

C B Collier1, S P Gatt, S M Lockley

  • 1Department of Anaesthesia, Royal Hospital for Women, Paddington, N.S.W., Australia.

British Journal of Anaesthesia
|April 1, 1993
PubMed
Summary
This summary is machine-generated.

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Accidental subdural block during Caesarean section was managed with fractionated local anesthetic doses. Continuous low-dose subdural infusion provided effective intraoperative and postoperative pain relief.

Area of Science:

  • Anesthesiology
  • Neurosurgery
  • Obstetrics

Background:

  • Attempted extradural anesthesia for Caesarean section can rarely result in accidental subdural block.
  • Subdural block is a potentially serious complication requiring careful management.

Observation:

  • A case of accidental subdural block occurred during an attempted extradural puncture for Caesarean section.
  • Fractionation of the local anesthetic dose was employed to mitigate potential complications.

Findings:

  • Subdural fentanyl administration and a continuous low-dose subdural infusion were successfully utilized.
  • Satisfactory intraoperative management and postoperative analgesia were achieved.
  • Low-dose bupivacaine (0.5 ml hourly) provided effective analgesia for 15 hours.

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Implications:

  • Fractionation of local anesthetic doses can prevent severe complications in accidental subdural blocks.
  • Continuous low-dose subdural infusions offer a viable strategy for managing intraoperative and postoperative pain in such cases.
  • This case highlights a potential alternative approach to neuraxial anesthesia complications.