CME Module 7: Accidental Subdural Injections Next >

 

Introduction

 

Throughout the clinical practice of anesthesia, there has been some confusion and misunderstanding regarding inadvertent subdural injections. This is in part due to the fact that classic teaching was that once the dura was breached by the epidural needle, the subarachnoid space was automatically entered. Essentially, there were 2 spaces that either the epidural needle or catheter could go astray and cause problems – subarachnoid or intravascular. In addition, in some of the older anesthesia literature the subarachnoid space was referred to as the subdural space. More recently, inadvertent subdural placement of epidural catheters has come to be recognized as a third possible place to go astray.

 

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