• Can J Anaesth · Jul 1989

    Case Reports

    Failure of a lidocaine test dose to identify subdural placement of an epidural catheter.

    • E T Crosby and S Halpern.
    • Department of Anaesthesia, Women's College Hospital, University of Toronto, Ontario.
    • Can J Anaesth. 1989 Jul 1;36(4):445-7.

    AbstractWe report the failure of a test dose of 3 ml lidocaine 1.5 per cent with 15 micrograms epinephrine to identify subdural placement of an epidural catheter in a parturient. Thirty-five minutes after injection of 13 ml lidocaine 1.5 per cent, intended to provide epidural analgesia, the patient developed an extensive sensory neural blockade. Some motor control was maintained and sympathetic block was incomplete. Blood pressure and oxygenation were easily supported with optimum positioning, fluids, ephedrine and oxygen by mask. The patient remained alert. The duration of neural blockade was approximately two hours. The patient underwent a second epidural for labour analgesia that was uneventful. There were no sequelae. Subdural injections are uncommon and unpredictable in their occurrence. Test doses do not consistently identify misplaced catheters. A negative response to a test dose does not guarantee that extensive neural blockade will not occur during epidural analgesia.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…