[Subdural anesthesia after epidural puncture: two case reports.]. 2003

Carlos Escobar Vásquez, and Tomio Tomita, and Antonio Bedin, and Renato Almeida Couto de Castro
CET, SBA, MEC.

OBJECTIVE Epidural anesthesia is a widely used procedure nowadays. Accidental subdural anesthesia after epidural puncture is an uncommon complication. This report aimed at describing two cases of subdural injection which coincidentally have happened in consecutive anesthesias induced by the same anesthesiologist. METHODS Case 1: Male patient, 41 years old, physical status ASA I, submitted to surgical ureteral calculi removal. Our choice was epidural anesthesia. Thirty minutes after beginning of induction, patient was communicative but sleepy with 100% SpO2, when he slowly began to show oxygen saturation decrease reaching 80% SpO2. Patient was unconscious with apnea and anisocoria. At this moment the diagnostic hypothesis was accidental subdural anesthesia. Patient was then intubated and maintained under mechanically controlled ventilation. After surgery, patient was referred to the recovery room and was discharged 6 hours after without any neurological complications. Case 2: Female patient, 82 years old, physical status ASA II, submitted to surgical proximal femur fracture fixation. Our choice in this case was continuous epidural anesthesia. Similar to the previous case, 30 minutes after she began to show SpO2 decrease, reaching 90%. Patient was uncons- cious with anisocoria, however without apnea. We decided to maintain the patient under constant surveillance and intubation was considered unnecessary. Our diagnostic hypothesis in this case was also accidental subdural anesthesia. At surgery completion patient was referred to the recovery room and was discharged 4 hours after without any neurological complication. CONCLUSIONS Accidental subdural anesthesia is a very uncommon complication. The diagnostic hypothesis, in our cases, was limited to clinical data. There are several subdural blockade complications, but most of the times they are easily managed, provided they are promptly diagnosed and treated.

UI MeSH Term Description Entries

Related Publications

Carlos Escobar Vásquez, and Tomio Tomita, and Antonio Bedin, and Renato Almeida Couto de Castro
February 1991, Acta anaesthesiologica Scandinavica,
Carlos Escobar Vásquez, and Tomio Tomita, and Antonio Bedin, and Renato Almeida Couto de Castro
May 2013, Der Anaesthesist,
Carlos Escobar Vásquez, and Tomio Tomita, and Antonio Bedin, and Renato Almeida Couto de Castro
April 2005, Masui. The Japanese journal of anesthesiology,
Carlos Escobar Vásquez, and Tomio Tomita, and Antonio Bedin, and Renato Almeida Couto de Castro
September 1983, Masui. The Japanese journal of anesthesiology,
Carlos Escobar Vásquez, and Tomio Tomita, and Antonio Bedin, and Renato Almeida Couto de Castro
January 1988, Annales francaises d'anesthesie et de reanimation,
Carlos Escobar Vásquez, and Tomio Tomita, and Antonio Bedin, and Renato Almeida Couto de Castro
January 1991, Clinical neurology and neurosurgery,
Carlos Escobar Vásquez, and Tomio Tomita, and Antonio Bedin, and Renato Almeida Couto de Castro
December 1985, Anaesthesia,
Carlos Escobar Vásquez, and Tomio Tomita, and Antonio Bedin, and Renato Almeida Couto de Castro
February 2022, Cureus,
Carlos Escobar Vásquez, and Tomio Tomita, and Antonio Bedin, and Renato Almeida Couto de Castro
March 2013, Masui. The Japanese journal of anesthesiology,
Carlos Escobar Vásquez, and Tomio Tomita, and Antonio Bedin, and Renato Almeida Couto de Castro
January 2007, JNMA; journal of the Nepal Medical Association,
Copied contents to your clipboard!