Total spinal anaesthesia following caudal block with bupivacaine and buprenorphine

G. Afshan, F. A. Khan

Research output: Contribution to journalArticlepeer-review

36 Citations (Scopus)


This is a case report of an 18-month-old 10 kg child who presented for emergency repair of a recurrent diaphragmatic hernia with a history of craniofacial dystosis and was given a caudal block postoperatively with a combination of 4 ml of 0.5% bupivacaine and 2.5 μg·kg-1 buprenorphine made up to a total volume of 10 ml. An inadvertent durai puncture occurred resulting in total spinal block which was managed symptomatically. Block regression started one h later when the respiratory movements became noticeable. Eye opening and hand movements returned 3 h later. The patient's exposure to a large intrathecal dose of buprenorphine did not lead to prolonged respiratory depression. The possibility of a midbrain insult due to a sudden rise in intracranial pressure is also discussed.

Original languageEnglish
Pages (from-to)239-242
Number of pages4
JournalPaediatric Anaesthesia
Issue number3
Publication statusPublished - 1996


  • Anaesthetic techniques: Regional
  • Caudal
  • Complications: Total spinal


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