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British Journal of Anaesthesia, Vol 76, Issue 2 322-324, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia

CASE REPORTS

Sudden onset of subarachnoid block after subdural catheterization: a case of arachnoid rupture?

D. W. Elliott, F. Voyvodic and P. Brownridge
Department of Anaesthesia and Intensive Care, Flinders Medical Centre, Bedford Park, South Australia 5042; Department of Radiology, Flinders Medical Centre, Bedford Park, South Australia 5042

We describe a patient who received an apparently uneventful extradural block in labour but developed rapid extension of neural block within minutes of receiving her first incremental dose 2 h later. Computed contrast tomography revealed radio-opaque dye within both the subdural and subarachnoid spaces, but none within the extradural space. This case report demonstrates that subdural spread of low-dose local anaesthetics is not always clinically distinguishable from extradural analgesia and that the arachnoid membrane may subsequently perforate with potentially serious consequences.
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