Document Detail


Subdural block and the anaesthetist.
MedLine Citation:
PMID:  20191772     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There are a number of case reports describing accidental subdural block during the performance of subarachnoid or epidural anaesthesia. However it appears that subdural drug deposition remains a poorly understood complication of neuraxial anaesthesia. The clinical presentation may often be attributed to other causes. Subdural injection of local anaesthetic can present as high sensory block, sometimes even involving the cranial nerves due to extension of the subdural space into the cranium. The block is disproportionate to the amount of drug injected, often with sparing of sympathetic and motor fibres. On the other hand, the subdural deposition can also lead to failure of the intended block. The variable presentation can be explained by the anatomy of this space. High suspicion in the presence of predisposing factors and early detection could prevent further complications. This review aims at increasing awareness amongst anaesthetists about inadvertent subdural block. It reviews the relevant anatomy, incidence, predisposing factors, presentation, diagnosis and management of unintentional subdural block during the performance of neuraxial anaesthesia.
Authors:
D Agarwal; M Mohta; A Tyagi; A K Sethi
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Anaesthesia and intensive care     Volume:  38     ISSN:  0310-057X     ISO Abbreviation:  Anaesth Intensive Care     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-03-02     Completed Date:  2010-03-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0342017     Medline TA:  Anaesth Intensive Care     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  20-6     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India. deeptisachin@yahoo.co.in
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, Epidural / adverse effects*
Anesthesia, Obstetrical
Anesthesia, Spinal / adverse effects*
Female
Humans
Medical Errors* / statistics & numerical data
Nerve Block / adverse effects*
Pregnancy
Subarachnoid Space
Subdural Space / anatomy & histology*,  injuries*

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


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