[Complete loss of brainstem-functions following epidural anaesthesia (author's transl)]

A 77 year old male patient developed complete loss of brainstem-functions following epidural anaesthesia for prostate electroresection. On the basis of anatomical and pathophysiological considerations an attempt is made to explain the development of this event. The most important factor seems to be that the local anaesthetic agent can diffuse into the subarachnoid space via the arachnoid villi, which can protrude into the epidural space. Once in the subarachnoid space the anaesthetic can ascend. By this mechanism a complete loss of brainstem functions may evolve. Survival without residual deficit is possible if immediate intensive care with control of the vital functions is instituted.