Dry Tap in a Pregnant Woman Undergoing Caesarean Section: An Anaesthetic Quagmire

“Dry tap", characterized by the lack of return of cerebrospinal fluid via the spinal needle following a dural puncture, is a distressing clinical conundrum for the anaesthesiologist. It assumes greater significance in situations where administering general anaesthesia is associated with significant risks, such as in pregnant women. Dry tap can have myriad causes, such as a blocked needle, incorrect technique, wrong space, and low cerebrospinal fluid pressure. Alternate neuraxial approaches, such as epidural anaesthesia, can be attempted in certain patients, but the risk of an unrecognized dural puncture must be borne in mind. Cases have been reported where a successful subarachnoid block has been administered despite obtaining a dry tap. However, the decision on the subsequent anaesthetic management after obtaining a dry tap rests on the attending anaesthesiologist and, hence, varies from one case to another.