Document Detail


Inadvertent subdural spread complicating cervical epidural steroid injection with local anaesthetic agent.
MedLine Citation:
PMID:  14601282     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although cervical epidural steroid injection with local anaesthetic is considered a safe technique and widely practiced, complications may occur. We report a patient experiencing unexpected delayed high block, moderate hypotension and unconsciousness eight to ten minutes after an apparently normal cervical epidural steroid injection. The most probable diagnosis was a subdural block. Anatomical peculiarities of the epidural and subdural space in the cervical region increase the risk of subdural spread during cervical epidural injection. Fluoroscopic guidance is important during cervical epidural injection to increase certainty of correct needle placement, thus minimizing the risk of complications.
Authors:
S Bansal; M J Turtle
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Anaesthesia and intensive care     Volume:  31     ISSN:  0310-057X     ISO Abbreviation:  Anaesth Intensive Care     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-11-06     Completed Date:  2004-04-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0342017     Medline TA:  Anaesth Intensive Care     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  570-2     Citation Subset:  IM    
Affiliation:
Anaesthetic Department, Walsgrave Hospital, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Analgesia, Epidural / adverse effects*,  methods
Anesthesia, Local*
Anesthetics, Local / administration & dosage
Anti-Inflammatory Agents / administration & dosage,  adverse effects
Bupivacaine / administration & dosage
Hemodynamics / drug effects
Humans
Male
Medical Errors / adverse effects*
Middle Aged
Muscle Weakness / chemically induced
Nerve Block
Respiration / drug effects
Spinal Osteophytosis / drug therapy
Steroids / administration & dosage,  adverse effects*
Subdural Space / drug effects
Triamcinolone Acetonide / administration & dosage,  adverse effects
Unconsciousness / chemically induced
Chemical
Reg. No./Substance:
0/Anesthetics, Local; 0/Anti-Inflammatory Agents; 0/Steroids; 2180-92-9/Bupivacaine; 76-25-5/Triamcinolone Acetonide
Comments/Corrections
Comment In:
Anaesth Intensive Care. 2004 Feb;32(1):145-6   [PMID:  15058141 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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