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A case of extensive block with the combined spinal-epidural technique during labour : case reports

✍ Scribed by I. C. Shaw; R. J. S. Birks

Publisher: John Wiley and Sons
Year: 2001
Tongue: English
Weight: 65 KB
Volume: 56
Category: Article
ISSN: 0003-2409
DOI: 10.1046/j.1365-2044.2001.01785.x

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✦ Synopsis

The increasing use of combined spinal-epidural analgesia in obstetric practice has arisen from a desire to achieve a rapid onset of analgesia while reducing the intensity of the motor block. Although the procedure has an excellent safety profile, as with any technique there are potential problems. Difficulty in assessing the position of the epidural catheter after establishment of the spinal blockade may lead to an abnormally extensive block when a full-strength local anaesthetic solution is used. We present a case in which the use of 0.5% bupivacaine to top-up the epidural component of a combined spinal-epidural resulted in a total spinal block. The possible causes of this complication are discussed.

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