Extensive epidural spread of cerebrospinal fluid displacing the spinal cord after an inadvertent dural puncture in an obstetric patient

A 24-year-old healthy primipara, body mass index (BMI) 34  kg/m2, had a difficult neuraxial labor analgesia insertion from a combined spinal-epidural (CSE) technique with an 18-gauge Tuohy needle and 27-gauge spinal needle. The first three attempts resulted in paresthesia in the thighs from the spinal needle before successful spinal needle insertion, ide ntification of the clear flow of cerebrospinal fluid (CSF) and intrathecal injection of fentanyl citrate (25 µg in a volume of 2 mL). Dural puncture with the epidural needle was not observed and the epidural catheter was expected to be in the epidural space.
Source: International Journal of Obstetric Anesthesia - Category: Anesthesiology Authors: Tags: Case Report Source Type: research