{"id":"https://openalex.org/W2031352014","doi":"https://doi.org/10.1213/00000539-199911000-00035","title":"Dilute Infusion for Labor, Obscure Subdural Catheter, and Life-Threatening Block at Cesarean Delivery","display_name":"Dilute Infusion for Labor, Obscure Subdural Catheter, and Life-Threatening Block at Cesarean Delivery","publication_year":1999,"publication_date":"1999-11-01","ids":{"openalex":"https://openalex.org/W2031352014","doi":"https://doi.org/10.1213/00000539-199911000-00035","mag":"2031352014","pmid":"https://pubmed.ncbi.nlm.nih.gov/10553848"},"language":"en","primary_location":{"id":"doi:10.1213/00000539-199911000-00035","doi":"https://doi.org/10.1213/00000539-199911000-00035","is_oa":false,"landing_page_url":"https://doi.org/10.1213/00000539-199911000-00035","pdf_url":null,"source":{"id":"https://openalex.org/S104698359","display_name":"Anesthesia & Analgesia","issn_l":"0003-2999","issn":["0003-2999","1526-7598"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-2","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Anesthesia & Analgesia","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5019424750","display_name":"Douglas J. Forrester","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I114027177","display_name":"University of North Carolina at Chapel Hill","ror":"https://ror.org/0130frc33","country_code":"US","type":"education","lineage":["https://openalex.org/I114027177"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Douglas J. Forrester","raw_affiliation_strings":["and reprint request to Douglas J. Forrester, MD, Department of Anesthesiology, The University of North Carolina at Chapel Hill, CB# 7010, 223 Burnett-Womack Bldg., Chapel Hill, NC 27599-7010","Department of Anesthesiology, School of Medicine, University of North Carolina at Chapel Hill, 27599-7010, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"and reprint request to Douglas J. Forrester, MD, Department of Anesthesiology, The University of North Carolina at Chapel Hill, CB# 7010, 223 Burnett-Womack Bldg., Chapel Hill, NC 27599-7010","institution_ids":["https://openalex.org/I114027177"]},{"raw_affiliation_string":"Department of Anesthesiology, School of Medicine, University of North Carolina at Chapel Hill, 27599-7010, USA","institution_ids":["https://openalex.org/I114027177"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5028900095","display_name":"Suresh Kumar Mukherji","orcid":"https://orcid.org/0000-0002-6472-0248","observed_orcids":["https://orcid.org/0000-0002-6472-0248"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Suresh K. Mukherji","raw_affiliation_strings":["University of North Carolina"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of North Carolina","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5035403143","display_name":"David C. Mayer","orcid":"https://orcid.org/0000-0002-8171-5715","observed_orcids":["https://orcid.org/0000-0002-8171-5715"]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"David C. Mayer","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5108404275","display_name":"Fred J. Spielman","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":true,"raw_author_name":"Fred J. Spielman","raw_affiliation_strings":["University of North Carolina"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of North Carolina","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5019424750","https://openalex.org/A5035403143","https://openalex.org/A5108404275"],"corresponding_institution_ids":["https://openalex.org/I114027177"],"apc_list":null,"apc_paid":null,"fwci":0.3442,"has_fulltext":false,"cited_by_count":10,"citation_normalized_percentile":{"value":0.5608903,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":88,"max":93},"biblio":{"volume":"89","issue":"5","first_page":"1267","last_page":"1267???1268"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10189","display_name":"Anesthesia and Pain Management","score":0.9976000189781189,"subfield":{"id":"https://openalex.org/subfields/2703","display_name":"Anesthesiology and Pain Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10189","display_name":"Anesthesia and Pain Management","score":0.9976000189781189,"subfield":{"id":"https://openalex.org/subfields/2703","display_name":"Anesthesiology and Pain Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12622","display_name":"Neurosurgical Procedures and Complications","score":0.0003000000142492354,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13323","display_name":"Spinal Hematomas and Complications","score":0.0003000000142492354,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/subdural-block","display_name":"subdural block","score":0.7649999856948853},{"id":"https://openalex.org/keywords/epidural-catheter","display_name":"epidural catheter","score":0.5960000157356262},{"id":"https://openalex.org/keywords/labor-epidural-analgesia","display_name":"labor epidural analgesia","score":0.847000002861023},{"id":"https://openalex.org/keywords/cesarean-section","display_name":"cesarean section","score":0.7080000042915344},{"id":"https://openalex.org/keywords/bupivacaine","display_name":"bupivacaine","score":0.699999988079071},{"id":"https://openalex.org/keywords/fentanyl","display_name":"fentanyl","score":0.6840000152587891},{"id":"https://openalex.org/keywords/epinephrine","display_name":"epinephrine","score":0.9150000214576721},{"id":"https://openalex.org/keywords/failed-intubation","display_name":"failed intubation","score":0.6990000009536743},{"id":"https://openalex.org/keywords/difficult-mask-ventilation","display_name":"difficult mask ventilation","score":0.7870000004768372},{"id":"https://openalex.org/keywords/rapid-sequence-induction","display_name":"rapid sequence induction","score":0.7839999794960022},{"id":"https://openalex.org/keywords/fiberoptic-intubation","display_name":"fiberoptic intubation","score":0.7879999876022339},{"id":"https://openalex.org/keywords/local-anesthetic-concentration","display_name":"local anesthetic concentration","score":0.5590000152587891},{"id":"https://openalex.org/keywords/obstetric-anesthesia-complications","display_name":"obstetric anesthesia complications","score":0.656000018119812}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.950884222984314},{"id":"https://openalex.org/C2781328992","wikidata":"https://www.wikidata.org/wiki/Q422806","display_name":"Bupivacaine","level":2,"score":0.7531407475471497},{"id":"https://openalex.org/C42219234","wikidata":"https://www.wikidata.org/wiki/Q131130","display_name":"Anesthesia","level":1,"score":0.7409126162528992},{"id":"https://openalex.org/C2781267111","wikidata":"https://www.wikidata.org/wiki/Q652297","display_name":"Catheter","level":2,"score":0.6742004752159119},{"id":"https://openalex.org/C2781072394","wikidata":"https://www.wikidata.org/wiki/Q407541","display_name":"Fentanyl","level":2,"score":0.644417405128479},{"id":"https://openalex.org/C2780149897","wikidata":"https://www.wikidata.org/wiki/Q216935","display_name":"Lidocaine","level":2,"score":0.6351777911186218},{"id":"https://openalex.org/C2777276199","wikidata":"https://www.wikidata.org/wiki/Q1346981","display_name":"Tuohy needle","level":4,"score":0.6161683201789856},{"id":"https://openalex.org/C2778994108","wikidata":"https://www.wikidata.org/wiki/Q1868462","display_name":"Local anesthetic","level":2,"score":0.560900092124939},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.4840502142906189},{"id":"https://openalex.org/C2775859304","wikidata":"https://www.wikidata.org/wiki/Q132621","display_name":"Epinephrine","level":2,"score":0.4108763337135315},{"id":"https://openalex.org/C2776651062","wikidata":"https://www.wikidata.org/wiki/Q2143681","display_name":"Seldinger technique","level":3,"score":0.08668696880340576}],"mesh":[{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000779","descriptor_name":"Anesthetics, Local","qualifier_ui":"Q000008","qualifier_name":"administration & dosage","is_major_topic":false},{"descriptor_ui":"D002045","descriptor_name":"Bupivacaine","qualifier_ui":"Q000008","qualifier_name":"administration & dosage","is_major_topic":false},{"descriptor_ui":"D002404","descriptor_name":"Catheterization","qualifier_ui":"Q000009","qualifier_name":"adverse effects","is_major_topic":false},{"descriptor_ui":"D002585","descriptor_name":"Cesarean Section","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010243","descriptor_name":"Paralysis","qualifier_ui":"Q000209","qualifier_name":"etiology","is_major_topic":false},{"descriptor_ui":"D013355","descriptor_name":"Subdural Space","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D015360","descriptor_name":"Analgesia, Epidural","qualifier_ui":"Q000009","qualifier_name":"adverse effects","is_major_topic":true},{"descriptor_ui":"D016362","descriptor_name":"Analgesia, Obstetrical","qualifier_ui":"Q000009","qualifier_name":"adverse effects","is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1213/00000539-199911000-00035","doi":"https://doi.org/10.1213/00000539-199911000-00035","is_oa":false,"landing_page_url":"https://doi.org/10.1213/00000539-199911000-00035","pdf_url":null,"source":{"id":"https://openalex.org/S104698359","display_name":"Anesthesia & Analgesia","issn_l":"0003-2999","issn":["0003-2999","1526-7598"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-2","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Anesthesia & Analgesia","raw_type":"journal-article"},{"id":"doi:10.1097/00000539-199911000-00035","doi":"https://doi.org/10.1097/00000539-199911000-00035","is_oa":false,"landing_page_url":"https://doi.org/10.1097/00000539-199911000-00035","pdf_url":null,"source":{"id":"https://openalex.org/S104698359","display_name":"Anesthesia & Analgesia","issn_l":"0003-2999","issn":["0003-2999","1526-7598"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-a","doyens","jufo-2","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Anesthesia & Analgesia","raw_type":"journal-article"},{"id":"pmid:10553848","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/10553848","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Anesthesia and analgesia","raw_type":"Case Reports"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.9763000011444092,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/case-report","display_name":"Case Report"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":35,"referenced_works":["https://openalex.org/W1519296739","https://openalex.org/W1785529372","https://openalex.org/W1968473767","https://openalex.org/W1970966969","https://openalex.org/W1973265035","https://openalex.org/W1973471270","https://openalex.org/W1975920594","https://openalex.org/W1985579185","https://openalex.org/W1995471040","https://openalex.org/W1996824579","https://openalex.org/W2009303160","https://openalex.org/W2032668267","https://openalex.org/W2032682910","https://openalex.org/W2035470666","https://openalex.org/W2042140562","https://openalex.org/W2046602819","https://openalex.org/W2047296813","https://openalex.org/W2048377410","https://openalex.org/W2061812575","https://openalex.org/W2061891594","https://openalex.org/W2074231327","https://openalex.org/W2080387083","https://openalex.org/W2081484869","https://openalex.org/W2102368058","https://openalex.org/W2108064652","https://openalex.org/W2145261060","https://openalex.org/W2147226398","https://openalex.org/W2161882897","https://openalex.org/W2167033979","https://openalex.org/W2317985809","https://openalex.org/W2413557931","https://openalex.org/W4232118640","https://openalex.org/W4237967963","https://openalex.org/W4242990379","https://openalex.org/W4301116734"],"related_works":["https://openalex.org/W2461747675","https://openalex.org/W4389257888","https://openalex.org/W4412545073","https://openalex.org/W2009759843","https://openalex.org/W2318110983","https://openalex.org/W2045591810","https://openalex.org/W2316414717","https://openalex.org/W4385455743","https://openalex.org/W4287837713","https://openalex.org/W1328276"],"abstract_inverted_index":{"Subdural":[0],"cannulation":[1],"occurs":[2,671],"in":[3,103,150,331,491,606,679,806,834,866],"0.82%":[4],"of":[5,23,30,40,56,157,255,261,388,436,439,470,478,488,506,531,540,557,564,595,655,668,705,773,799,829,887],"epidural":[6,48,456,493,511,572,660,793],"catheter":[7,63,116,216,365,390,419,516,548,596,661,692,708,714,723],"attempts":[8,360],"(1).":[9],"Presentation":[10],"may":[11,46,513,591],"include":[12,615],"delayed,":[13],"extensive":[14],"sensory":[15,207],"block":[16,20,32,60,72,146,208,298,497,732,751,805,855],"(2\u20137),":[17],"grossly":[18],"asymmetric":[19],"(2\u20135),":[21],"sparing":[22,477],"sacral":[24],"dermatomes":[25],"(2,4,5,7),":[26],"and":[27,127,140,153,167,172,209,231,245,252,276,299,304,314,318,346,355,368,391,485,526,559,573,588,620,741,757,771,869],"varying":[28],"degrees":[29],"motor":[31,496,760,804,827,871],"(2\u20137).":[33],"The":[34,115,215,762,797],"trend":[35,501],"toward":[36,502],"using":[37,503],"smaller":[38,504],"concentrations":[39,505],"local":[41,507,632,858,888],"anesthetic":[42,508,633,889],"for":[43,187,328,509,612,635,812,862,890],"labor":[44,71,84,510,581,854,891],"analgesia":[45,512,582],"make":[47],"evaluation":[49],"more":[50],"difficult.":[51],"We":[52,518,534],"present":[53],"a":[54,57,62,68,83,88,96,128,237,253,262,374,381,447,450,453,541,813,845,852],"case":[55,521,614,808,815],"profound":[58,731],"subdural":[59,386,437,532,552,574,617,622,711,722,750,789,830,896],"from":[61,363,449,544,626],"that":[64,560,604,653,666,748,787,816,825,883],"had":[65],"previously":[66,579],"provided":[67,851],"relatively":[69,663],"normal":[70,308,853],"with":[73,95,112,147,223,402,452,476,537,630,724,737,856],"diluted":[74],"bupivacaine/fentanyl/epinephrine.":[75],"Case":[76],"Report":[77],"A":[78,721],"healthy":[79],"33-yr-old":[80],"woman":[81],"received":[82],"epidural,":[85],"placed":[86],"on":[87,164,169],"single":[89,814],"pass":[90],"at":[91,220,242,316,554,716,733],"the":[92,104,124,145,165,170,173,192,195,200,221,292,296,323,347,351,364,369,389,392,430,440,461,466,471,479,492,500,528,538,545,551,555,561,601,607,631,641,669,691,703,710,717,730,785,788,792,800,826,884,893],"L3-4":[93],"interspace,":[94],"17-gauge":[97],"Tuohy-Schliff":[98],"needle,":[99],"while":[100],"she":[101],"was":[102,109,118,162,185,218,234,259,271,326,344,566,817],"sitting":[105],"position.":[106],"Needle":[107],"entry":[108],"bevel":[110],"cephalad,":[111],"no":[113,403],"rotation.":[114],"(closed-tip)":[117],"threaded":[119,549],"to":[120,189,361,568,623,688,701,775,836],"4":[121],"cm":[122],"beyond":[123],"Tuohy;":[125],"aspiration":[126],"spinal":[129],"test":[130,239],"dose":[131,240],"were":[132,307,312,366],"negative.":[133],"Using":[134],"bupivacaine":[135,586],"0.04%,":[136],"fentanyl":[137,228],"1.7":[138],"\u03bcg/mL,":[139,230],"epinephrine":[141,232],"1:600,000,":[142],"we":[143],"initiated":[144],"15":[148,158,256],"mL":[149,396],"divided":[151],"doses":[152],"then":[154,246],"an":[155,204,288,524,571,659,676,776,841],"infusion":[156],"mL/hour.":[159],"Sensory":[160],"level":[161],"T-8":[163],"left":[166,211],"T-10":[168],"right,":[171],"patient":[174,196,348,370,379,423,451],"remained":[175,719],"comfortable":[176],"without":[177],"further":[178],"boluses.":[179],"After":[180,249,378],"6":[181],"h,":[182],"cesarean":[183,293,863],"delivery":[184,864],"recommended":[186],"failure":[188],"progress.":[190],"In":[191,421,576,843],"operating":[193,608],"room,":[194],"moved":[197],"herself":[198],"onto":[199],"table;":[201],"examination":[202],"revealed":[203,385],"appropriately":[205],"dense":[206],"moderate":[210],"lower":[212,335,802],"extremity":[213,336,803],"weakness.":[214],"position":[217,715],"unchanged":[219],"skin,":[222],"negative":[224,739],"aspiration.":[225],"Lidocaine":[226],"2%,":[227],"5":[229,243,319],"1:200,000":[233],"used":[235,580],"as":[236,849],"3-mL":[238],"(negative":[241],"min)":[244],"incrementally":[247],"dosed.":[248],"10":[250,284,340],"min":[251],"total":[254,867],"mL,":[257],"there":[258],"evidence":[260],"high":[263,754],"block,":[264],"followed":[265],"by":[266,273,658,768,784],"apnea.":[267],"Rapid":[268],"sequence":[269],"induction":[270],"complicated":[272],"unsuccessful":[274],"intubation":[275],"difficult":[277],"mask":[278,353],"ventilation.":[279],"Diaphragmatic":[280],"movement":[281],"resumed":[282],"after":[283,287,415],"min,":[285,320,333],"and,":[286,598],"oral":[289,777],"fiberoptic":[290,357,778],"intubation,":[291,779],"proceeded":[294],"under":[295],"residual":[297],"general":[300],"anesthesia.":[301],"Blood":[302],"pressure":[303],"heart":[305],"rate":[306],"throughout;":[309],"Apgar":[310],"scores":[311],"7":[313],"8":[315],"1":[317],"respectively.":[321],"Although":[322,495,873],"patient's":[324],"strength":[325],"sufficient":[327],"tracheal":[329],"extubation":[330],"90":[332],"complete":[334,769],"recovery":[337,343],"took":[338],"approximately":[339],"h.":[341],"Neurologic":[342],"complete,":[345],"recalled":[349],"only":[350],"initial":[352],"ventilation":[354],"awake":[356],"intubation.":[358],"Repeated":[359],"aspirate":[362],"negative,":[367],"did":[371],"not":[372,644,818],"develop":[373],"postdural":[375],"puncture":[376],"headache.":[377],"consent,":[380],"computed":[382,411],"tomography":[383,412],"scan":[384],"location":[387],"injected":[393],"dye":[394],"(3":[395],"Omnipaque;":[397],"Nycomed,":[398],"Inc.,":[399],"Princeton,":[400],"NJ),":[401],"subarachnoid":[404,624],"spread":[405,756],"(Figure":[406],"1).Figure":[407],"1:":[408],"Lumbar":[409],"axial":[410],"(CT)":[413],"images":[414],"contrast":[416,425,441,462,489],"injection":[417],"through":[418,640],"(\u201ccathetergram\u201d).":[420],"our":[422,459,547,613,706,738,807,822],"(A)":[424],"material":[426,463],"(arrows)":[427],"circumferentially":[428],"outlines":[429],"thecal":[431,472],"sac":[432,473],"(T),":[433],"strongly":[434],"suggestive":[435],"confinement":[438],"material.":[442],"For":[443],"comparison":[444],"(B)":[445],"is":[446,486,498,662,809],"\u201ccathetergram\u201d":[448],"normally":[454],"functioning":[455],"catheter.":[457],"Unlike":[458],"case,":[460],"appears":[464,735,881],"along":[465],"nondependent":[467],"anterior":[468],"portion":[469,482],"(straight":[474],"arrows),":[475],"dependent":[480],"posterior":[481],"(curved":[483],"arrow),":[484],"typical":[487],"located":[490],"space.Discussion":[494],"minimized,":[499],"obscure":[514],"dangerous":[515],"malpositions.":[517],"believe":[519],"this":[520,577,749],"represents":[522],"such":[523],"event":[525],"demonstrates":[527],"unpredictable":[529],"nature":[530],"blocks.":[533],"suspect":[535],"that,":[536],"aid":[539],"dural":[542],"rent":[543],"Tuohy,":[546],"into":[550],"space":[553],"time":[556],"placement":[558],"dilute":[562,857,885],"concentration":[563,886],"bupivacaine/fentanyl/epinephrine":[565],"inadequate":[567],"discriminate":[569],"between":[570],"location.":[575,897],"regard,":[578],"techniques":[583],"(e.g.,":[584],"0.25%":[585],"initiation":[587],"0.125%":[589],"infusion)":[590],"have":[592],"raised":[593],"suspicions":[594],"malposition":[597],"thus,":[599],"prevented":[600],"near":[602],"catastrophe":[603],"occurred":[605],"room.":[609],"Alternative":[610],"explanations":[611],"delayed":[616,874],"migration":[618,639,684,875],"(8)":[619],"sudden":[621],"conversion":[625],"arachnoid":[627,670,726],"membrane":[628],"rupture":[629],"bolus":[634],"surgery":[636],"(9,10).":[637],"Delayed":[638],"dura,":[642],"but":[643,665,860],"arachnoid,":[645],"seems":[646],"less":[647,682],"likely,":[648],"given":[649],"laboratory":[650],"findings":[651],"showing":[652],"penetration":[654,667],"intact":[656],"dura":[657],"difficult,":[664],"easily":[672],"(11).":[673],"Additionally,":[674],"unlike":[675,791],"open-tip":[677],"catheter,":[678,846],"which":[680],"presumably":[681],"forward":[683,696],"would":[685,698],"be":[686,781,877],"necessary":[687,700],"functionally":[689],"change":[690],"tip":[693],"position,":[694],"significant":[695],"advancement":[697],"seem":[699],"locate":[702],"holes":[704],"closed-tip":[707],"within":[709],"space;":[712],"however,":[713],"skin":[718],"unchanged.":[720],"subsequent":[725],"rupture,":[727],"though":[728],"explaining":[729],"cesarean,":[734],"inconsistent":[736],"aspirations":[740],"radiologic":[742],"findings.":[743],"Our":[744],"literature":[745],"review":[746,823],"suggests":[747],"exhibited":[752],"unusually":[753],"cephalad":[755],"exceptionally":[758],"prolonged":[759,801,870],"block.":[761,872],"apparent":[763],"cranial":[764],"nerve":[765],"anesthesia,":[766],"judged":[767],"apnea":[770],"lack":[772],"response":[774],"can":[780],"explained":[782],"anatomically":[783],"fact":[786],"space,":[790,794],"extends":[795],"intracranially.":[796],"etiology":[798],"unclear.":[810],"Except":[811],"radiologically":[819],"documented":[820],"(12),":[821],"indicates":[824],"component":[828],"blocks":[831],"typically":[832],"resolves":[833],"two":[835],"three":[837],"hours,":[838],"much":[839],"like":[840],"epidural.":[842],"summary,":[844],"later":[847],"proven":[848],"subdural,":[850],"anesthetic,":[859],"dosing":[861],"resulted":[865],"paralysis":[868],"cannot":[876],"ruled":[878],"out,":[879],"it":[880],"likely":[882],"obscured":[892],"presumed,":[894],"hazardous,":[895]},"counts_by_year":[{"year":2024,"cited_by_count":1}],"updated_date":"2026-11-08T12:12:28.789561","created_date":"2016-06-24T00:00:00"}