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Uneventful extradural analgesia after unrecognized dural perforation

  • Sergio Gregoretti
Article

Summary

A case is reported of an uneventful continuous extradural block in spite of unrecognized durai perforation. Although the perforation was recognized later during the block, the dura was probably pierced during the insertion of the catheter and only later the terminal hole came to lie in the subarachnoid space. Consequently both extradural and subarachnoid spread of the injected local anaesthetic occurred, preventing an extensive subarachnoid block.

Keywords

Bupivacaine Subarachnoid Space Epidural Space Subarachnoid Block Extradural Space 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Ľauteur rapporte un cas ďanalgésie péridurale sans complications cliniques, malgré une perforation non reconnue de la dure-mère. Bien que ľon se soit rendu compte de la perforation tardivement en cours ďintervention, celle-ci est probablement survenue au cours de ľinsertion du cathéter. Ce dernier est vraisemblablement venu se placervis-à-vis ľouverture dure-méridienne à la suite des doses de rappel ďanesthésique, la solution se distribuant dans les deux espaces (sousdural et péridural), ce qui explique ľabsence ďun bloc sous-arachnoïdien total.

References

  1. 1.
    Carr, M.F. &Hehre, F.W. Complications of continuous lumbar peridural anesthesia. I. Inadvertent lumbar puncture. Anesth. & Analg.41: 349–353 (1962).Google Scholar
  2. 2.
    Moir, D.D. &Hesson, W.R. Durai puncture by an epidural catheter. Anaesthesia20: 373–374 (1965).CrossRefGoogle Scholar
  3. 3.
    Crawford, J.S. Lumbar epidural block in labour: a clinical analysis. Brit. J. Anaesth.44: 66–74 (1972).PubMedCrossRefGoogle Scholar
  4. 4.
    Crawford, J.S. The strange case of the inadvertent continuous spinal. Brit. J. Anaesth.46: 82 (1974).PubMedCrossRefGoogle Scholar
  5. 5.
    Reisner, I.S. Epidural test solution or spinal fluid? Anesthesiology44: 451 (1976).PubMedCrossRefGoogle Scholar
  6. 6.
    Philip, J.H. &Brown, W.V. Total spinal anesthesia late in the course of obstetric bupivacaine epidural block. Anesthesiology44: 340–341 (1976).PubMedCrossRefGoogle Scholar
  7. 7.
    Hartley, M. The strange case of inadvertent spinal. Brit. J. Anaesth.47: 420 (1975).PubMedCrossRefGoogle Scholar
  8. 8.
    Davis, H. Specific gravity and density. Anesthesiology44: 270–271 (1976).PubMedGoogle Scholar
  9. 9.
    Kallos, T. &Smith, T.C. Continuous spinal anesthesia with hypobaric tetracaine for hip surgery in lateral decubitus. Anesth. & Analg.51: 766–773 (1972).CrossRefGoogle Scholar

Copyright information

© Canadian Anesthesiologists 1978

Authors and Affiliations

  • Sergio Gregoretti
    • 1
    • 2
  1. 1.Department of AnaesthesiaRoyal Victoria HospitalMontrealQue.
  2. 2.Dept. of AnaesthesiaOspedale MaggioreTriesteItaly

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