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Inadvertent Subdural Injection

A Complication of an Epidural Block

Department of Anesthesiology, Rush Presbyterian St. Luke's Medical Center, Chicago, Illinois.

Abstract

Twenty-one hundred eighty two consecutive lumbar epidural injections were studied to determine the incidence of inadvertent subdural block retrospectively. A subdural block is defined as an extensive neural block in the absence of subarachnoid puncture, that is out of proportion to theamount of local anesthetic injected. Subdural injection is a complicationof epidural block that probably occurs more frequently than previously recognized. An earlier report has estimated the incidence of subdural blockto be 0.1%. This study, however, reports an incidence of 0.82% from a sample size of 2182 patients. Cadaveric dissection was also performed, further clarifying the presence and anatomic position of the subdural space.

Key Words: ANESTHETIC TECHNIQUES— epidural.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999