ACCIDENTAL SUBDURAL ANALGESIA: A case report, possible clinical implications and relevance to "massive extradurals"

A continuous obstetric epidural is described, in which an abnormally extensive block and hypotension resulted. The catheter was subsequently shown to enter the subdural space. As this case resembles a "massive epidural", it is suggested that subdural injec-tion may explain the phenomenon. Extradural blocks often exhibit atypical features. The case described was shown to be the result of a subdural injection of local anaesthetic agent. It is suggested that accidental injection into the subdural space may explain the "massive extradurals " des-cribed by Massey Dawkins (1969). Although sub-dural phenol injections are used in the relief of chronic pain (Maher, 1957), we can find no reports of subdural analgesia occurring during the performance of an extradural block. CASE REPORT AND DISCUSSIO