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Total spinal anaesthesia as a complication of local anaesthetic test‐dose administration through an epidural catheter
Author(s) -
Steffek M.,
Owczuk R.,
SzlykAugustyn M.,
LasinskaKowara M.,
Wujtewicz M.
Publication year - 2004
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2004.00500.x
Subject(s) - medicine , anesthesia , catheter , local anaesthetic , epidural space , general anaesthesia , surgery , complication , spinal cord , psychiatry
We describe a case of total spinal anaesthesia, which occurred after a 3‐ml lignocaine (20 mg ml −1 ) test dose was administered through an epidural catheter in a 79‐year‐old patient scheduled for gastrectomy under combined general and epidural anaesthesia. The surgery was postponed, and the patient required admission to the intensive therapy unit. Spinal MRI from the total spinal cord did not reveal any pathology. During the next 24 h the patient recovered and after 11 days was successfully operated on under general anaesthesia. No late complications followed. We presume that during placement, the epidural catheter had migrated to the spinal canal as a result of technical difficulties. Although controversial, we consider that administering a standard test dose of local anaesthetic via an epidural catheter is recommended, especially in high‐risk patients and when epidural space identification or catheter placement poses technical difficulties. A test dose of local anaesthetic does not fully prevent complications.