Local and regional anaesthesia: subdural injection: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Local and regional anaesthesia: subdural injection

Sample item

Fifteen minutes after an epidural top-up, a woman develops an unexpectedly high but patchy block that spares some segments, with mild hypotension, a Horner-type picture and hoarseness. Breathing is preserved. Which complication fits best?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Subdural injection

Local anaesthetic placed in the subdural space spreads with a delayed onset, extensive but patchy block, and cranial spread with relatively little hypotension or motor loss. A total spinal appears within minutes with apnoea and unconsciousness, and intravascular injection causes toxicity features rather than a high block.

Option by option

  • A. Intravascular injection

    Intravascular injection would cause tinnitus, perioral numbness or seizure, not a high patchy block.

  • B. Epidural haematoma

    A haematoma causes back pain and progressive cord signs, not a spreading block.

  • C. Total spinal anaesthesia

    Total spinal develops within minutes with apnoea and loss of consciousness.

  • D. Subdural injection (correct)

    Correct. Delayed, extensive and patchy spread with modest hypotension fits a subdural injection.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Subdural injection. Local anaesthetic placed in the subdural space spreads with a delayed onset, extensive but patchy block, and cranial spread with relatively little hypotension or motor loss.

Why is "Intravascular injection" not the answer?

Intravascular injection would cause tinnitus, perioral numbness or seizure, not a high patchy block.

Why is "Epidural haematoma" not the answer?

A haematoma causes back pain and progressive cord signs, not a spreading block.

Why is "Total spinal anaesthesia" not the answer?

Total spinal develops within minutes with apnoea and loss of consciousness.

What concept does this question test?

It tests Local and regional anaesthesia: subdural injection in Anaesthesia. A total spinal appears within minutes with apnoea and unconsciousness, and intravascular injection causes toxicity features rather than a high block.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Local and regional anaesthesia: subdural injection?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.