Abstract
Central neuraxial blockade is a commonly performed anaesthetic technique for lower limb orthopaedic surgeries. Although it is considered a safe and reliable technique, occasionally an unexpectedly high or low level of block can be achieved due to accidental injection of local anaesthetic in a meningeal plane other than that desired. Here we report a young male who complained of aphasia and difficulty in breathing immediately after spinal anaesthesia. He had a high sensory block extending to C3 dermatome. His haemodynamics remained stable throughout the surgery. Speech returned to normal in 15 minutes. Subdural block was speculated as a cause for this unusual presentation
Highlights
Case Report Central neuraxial blockade is a common anaesthetic technique for lower limb orthopaedic surgeries
Spinal anaesthesia conducted under standard conditions carries a poorly understood risk of sudden cardiac arrest and severe brain injury in healthy patients.[2]
The problems encountered in this patient were a very high sensory block with transient aphasia, motor weakness of the upper limbs and difficulty in breathing
Summary
Case Report Central neuraxial blockade is a common anaesthetic technique for lower limb orthopaedic surgeries. It is considered a safe and reliable technique, occasionally an unexpectedly high or low level of block occurs due to accidental injection of local anaesthetic in a meningeal plane other than that desired.[1] Even cardiac arrests have been reported despite stable haemodynamics.[2] A greater awareness about variable presentations is important as timely management is essential to avoid critical complications. We hereby report a case that developed aphasia with unexpectedly high sensory level immediately following spinal anaesthesia.
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