Another Misplaced Epidural Catheter

Unrecognised accidental placement of an epidural catheter into the subarachnoid space is a potentially serious complication because a subsequent incremental dose may cause an unexpected and rapid onset of high spinal blockade requiring urgent resuscitation.The following case report describes an obstetric patient who received two incremental doses via an epidural catheter which was later proven radiologically to have been in the subarachnoid space.The unremarkable response of the patient to a weak bupivacaine/pethidine mixture during labour is compared with that which occurred following 2070 lignocaine prior to caesarean section.CASE REPORT A 28-year-old mother requested an epidural block for pain relief during labour.An 18 SWG winged Crawford epidural needle was inserted in the midline at the L 1-2 interspace and advanced using the intermittent 'loss of resistance to air' method to locate the epidural space.Bone was contacted at the first attempt