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  • Title: Unintentional combined epidural and subdural block. Case report.
    Author: Chauhan S, Gaur A, Tripathi M, Kaushik S.
    Journal: Reg Anesth; 1995; 20(3):249-51. PubMed ID: 7547665.
    Abstract:
    BACKGROUND AND OBJECTIVES: Unintentional subdural block, while attempting an epidural anesthetic, is a rare but known complication. The authors describe a radiologically confirmed case of an unintentional combined epidural and subdural block while attempting to perform an epidural block for transurethral resection of prostate in a middle-aged man. METHODS: Loss of resistance to air injection was used for identifying the epidural space prior to catheter placement. Following the epidural injection of 20 mL of a 1.5% lidocaine and 0.5% bupivacaine mixture, the patient developed rapid, intense, prolonged, and extensive bilateral motor block up to C2 level. RESULTS: The patient had aphonia and respiratory paralysis requiring endotracheal intubation and controlled ventilation for 3 hours. CONCLUSIONS: Postoperative radiologic examination revealed the spread of the dye in both epidural and subdural spaces, causing the extensive sensory and motor block.
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