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VOLUME 19 , ISSUE 2 ( 2015 ) > List of Articles

CASE REPORT

Cerebral venous air embolism during epidural injection in adult

Banambar Ray, Sharmili Sinha

Keywords : Air embolism, cerebral circulation, epidural catheter, epidural injection, postoperative analgesia, venous

Citation Information : Ray B, Sinha S. Cerebral venous air embolism during epidural injection in adult. Indian J Crit Care Med 2015; 19 (2):116-118.

DOI: 10.4103/0972-5229.151021

License: CC BY-ND 3.0

Published Online: 01-02-2015

Copyright Statement:  Copyright © 2015; The Author(s).


Abstract

A bolus of 0.125% bupivacaine (8ml) was given for post-operative analgesia with considerable resistance. It was immediately followed by hemodynamic deterioration along with fall in sensorium. After resuscitation, CT brain revealed pneumoencephalus around the brainstem. The higher force generated during injection could have injured epidural venous plexus and air inadvertently entered the veins. The source of air could have been from the epidural catheter or injection syringe. Hence it is suggested that position and patency of the epidural catheter must be checked each time before administration of injections especially after position changes. On presence of slightest resistance, injections should be withheld till the cause is ascertained by a trained personnel.

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