Accidental deposition of local anaesthetic in the subdural space following caudal block

Abstract

The incidence of accidental injection of local anaesthetic into the subdural space during neuraxial blockade is rare. The presentation of unexplainable clinical signs that do not match the clinical picture of subarachnoid or intravascular injection of the local anaesthetic agent should invoke high suspicion of unintentional subdural block. We report on a case of a sixmonth- old infant who developed motor block and unconsciousness with haemodynamic stability, following a caudal block for postoperative analgesia. The report will help to illustrate the mechanism behind the complication of subdural deposition of the drug, its detection, treatment and possible avoidance.

Keywords: caudal, subdural, injection, local anaesthetic