[Subdural catheterization uncovered by severe hypotension during epidural plus general anesthesia]. 1995

A Okuyama, and Y Saito, and H Amenomori, and M Okuyama, and S Kobayashi, and O Kemmotsu
Department of Anesthesia, Asahikawa Kosei Hospital.

We experienced three cases of accidental subdural catheterization during epidural combined with general anesthesia. In each case, epidural catheterization was performed before induction of general anesthesia. Aspiration through the catheter and a response to a test dose were negative. Then anesthesia was induced with thiamylal IV and the trachea was intubated with vecuronium IV. Hypotension, which was not easily treated by vasopressors and volume load, occurred after administration of 3 to 8 ml mepivacaine with 1: 200,000 epinephrine through the catheter. We examined position of the catheter by injecting iohexol 240 and confirmed subdural catheterization after surgery. It is often difficult to identify subdural placement of an epidural catheter under general anesthesia since signs of massive sensory blockade are masked by general anesthesia. In each case, we suspected malpositioning of the catheter by severe hypotension due to sympatholysis which was difficult to treat. Subdural catheterization is a complication of epidural anesthesia that probably occurs more frequently than previously recognized and is usually unpredictable during general anesthesia.

UI MeSH Term Description Entries
D007022 Hypotension Abnormally low BLOOD PRESSURE that can result in inadequate blood flow to the brain and other vital organs. Common symptom is DIZZINESS but greater negative impacts on the body occur when there is prolonged depravation of oxygen and nutrients. Blood Pressure, Low,Hypotension, Vascular,Low Blood Pressure,Vascular Hypotension
D007431 Intraoperative Complications Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure. Peroperative Complications,Surgical Injuries,Complication, Intraoperative,Complication, Peroperative,Injuries, Surgical,Complications, Intraoperative,Complications, Peroperative,Injury, Surgical,Intraoperative Complication,Peroperative Complication,Surgical Injury
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002406 Catheterization, Peripheral Insertion of a catheter into a peripheral artery, vein, or airway for diagnostic or therapeutic purposes. Arterial Catheterization, Peripheral,Catheterization, Bronchial,Catheterization, Peripheral Arterial,Catheterization, Peripheral Venous,Peripheral Catheterization,Venous Catheterization, Peripheral,Bronchial Catheterization,PICC Line Catheterization,PICC Line Placement,PICC Placement,Peripheral Arterial Catheterization,Peripheral Venous Catheterization,Peripherally Inserted Central Catheter Line Insertion,Arterial Catheterizations, Peripheral,Bronchial Catheterizations,Catheterization, PICC Line,Catheterizations, Bronchial,Catheterizations, PICC Line,Catheterizations, Peripheral,Catheterizations, Peripheral Arterial,Catheterizations, Peripheral Venous,PICC Line Catheterizations,PICC Line Placements,PICC Placements,Peripheral Arterial Catheterizations,Peripheral Catheterizations,Peripheral Venous Catheterizations,Placement, PICC,Placement, PICC Line,Placements, PICC,Placements, PICC Line,Venous Catheterizations, Peripheral
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000767 Anesthesia, Epidural Procedure in which an anesthetic is injected into the epidural space. Anesthesia, Extradural,Anesthesia, Peridural,Epidural Anesthesia,Anesthesias, Epidural,Anesthesias, Extradural,Anesthesias, Peridural,Epidural Anesthesias,Extradural Anesthesia,Extradural Anesthesias,Peridural Anesthesia,Peridural Anesthesias
D000768 Anesthesia, General Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery. Anesthesias, General,General Anesthesia,General Anesthesias
D013355 Subdural Space Potential cavity which separates the ARACHNOID MATER from the DURA MATER. Space, Subdural,Subdural Spaces

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