Transient aphasia following spinal anaesthesia in an orthopaedic patient

Abstract

A 50-year-old male [American Society of Anesthesiologists (ASA) grade II] was scheduled for lower limb orthopaedic surgery. The subarachnoid space was localised with difficulty at L3/4 interspace and 3 ml of hyperbaric bupivacaine was given. Within a few minutes, the patient developed aphasia with a very high sensory block extending to C2 dermatome, followed by apnoea. The patient remained haemodynamically stable throughout surgery and respiration resumed within five minutes. Inadvertent subdural deposition of local anaesthetic was speculated to be the cause of this unusual presentation.