November 1, 1999Anesthesia & Analgesia

Dilute Infusion for Labor, Obscure Subdural Catheter, and Life-Threatening Block at Cesarean Delivery

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Population

1 healthy 33-yr-old woman receiving a labor epidural

Design

Case_report

Follow-up

approximately 10 hours

Authors

DFDouglas J. ForresterJohns Hopkins University SMSuresh K. MukherjiUniversity of Louisville DMDavid C. MayerUniversity of North Carolina at Chapel Hill

Discussion

Member takes

Implication

Subdural catheter placement risks life-threatening high blocks despite dilute labor analgesia; leaves open reliable detection strategies.

Structured PICO

Population

1 healthy 33-yr-old woman receiving a labor epidural

Intervention

Epidural catheter placement with dilute bupivacaine (0.04%), fentanyl (1.7 μg/mL), and epinephrine (1:600,000) for labor, subsequently dosed with lidocaine 2%, fentanyl 5 μg/mL, and epinephrine 1:200,000 for cesarean delivery

Outcome

Development of profound subdural block with apnea and prolonged motor blocksafety

The use of dilute local anesthetic concentrations for labor analgesia may obscure dangerous subdural catheter malpositions, which can lead to life-threatening high blocks when dosed for cesarean delivery.

Cite This Study

Forrester et al. (1999) studied this question.

synapsesocial.com/papers/6a89964caf65c378f7fd46a3 https://doi.org/10.1213/00000539-199911000-00035

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Dilute Infusion for Labor, Obscure Subdural Catheter, and Life-Threatening Block at Cesarean Delivery

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Dilute Infusion for Labor, Obscure Subdural Catheter, and Life-Threatening Block at Cesarean Delivery

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Also Consider

Also Consider