50th Annual Regional Anesthesiology and Acute Pain Medicine Meeting

Inadvertent Subdural Catheter Placement during Cesarean Section Delivery

Arundhati Pillai B.S., B.A.1 , Venkat Tummala B.S.1 , Karen Back B.S.1 , Cheng-ting Lee M.D.1,2

1.Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA

2.Carle Foundation Hospital, Urbana, Illinois, USA

Introduction:

•Epidural neuraxial analgesia widely used for pain management in labor/delivery

•Rare complication = inadvertent placement of catheter into the subdural space

•Can cause subdural block – unpredictable clinical picture differing from typical epidural or subarachnoid blocks

Symptoms:

•Delayed or gradual onset of anesthesia

•Extensive sensory block with minimal motor involvement

•Hypotension

•Intracranial dispersion of anesthetic à dyspnea, loss of consciousness

•Conjunctival injection

•Miosis

•Abdominal respiration

•Epidural hematoma.

Case: Pregnant woman in labor with functioning lumbar epidural catheter developed symptoms consistent with high spinal anesthesia during urgent cesarean section for category II fetal heart tracing.

50th Annual Regional Anesthesiology and Acute Pain Medicine Meeting

INADVERTENT SUBDURAL CATHETER PLACEMENT DURING CESAREAN SECTION DELIVERY

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