Subdural hematoma following labor analgesia utilizing an intrathecal catheter

摘要

To the Editor: We report a subdural hematoma following repeated neuraxial analgesia during labor. A healthy parturient presented with an unremarkable preanesthetic examination. At L3-L4, an 18-gauge Tuohy was advanced until a depth of 4 cm. Free-flowing cerebral spinal fluid (CSF) confirmed accidental dural puncture. A 20-gauge catheter was advanced 4 cm into the intrathecal space (IT) and secured at 8 cm at the skin. One milliliter bupivacaine 0.25 % with sufentanil 5 mug preceded infusion of bupivacaine 0.0625 % with fentanyl 1.5 mug/ml and epinephrine 1:700,000 at 2 ml/ h. Four hours later, analgesia became less potent.