Osuga K, Hirabayashi Y, Fukuda H, Shimizu R, Asahara H
Department of Anesthesiology, Jichi Medical School, Tochigi.
Masui. 1999 Jan;48(1):67-9.
We report a case in which spinal anesthesia induced a severe lightning limb pain. A 71-year-old man presented for prostate biopsy. Preanesthetic examinations revealed slight hypesthesia in the L 5-S 1 dermatomal segments in the right leg. The patient reported that he had received "local anesthetic" in the lumbar spine 16 years previously because of severe lumbago, and that his hyposthesia had originated from the "local anesthetic". Unfortunately we had no way to know the anesthetic technique performed 16 years ago. The spinal anesthesia was uneventfully introduced with a 25 G Quincke needle at the L 3-4 interspace using 2.0 ml 0.3% hyperbaric dibucaine in the left lateral positions. As soon as the patient was put into the supine position, he started to complain about severe lightning pain in the region of his hyposthesic segments. Severe lightning pain completely diminished 4 hours later when the effect of spinal anesthesia disappeared.
我们报告一例脊髓麻醉诱发严重闪电样肢体疼痛的病例。一名71岁男性因前列腺活检前来就诊。麻醉前检查发现其右腿L5 - S1皮节区有轻微感觉减退。患者自述16年前因严重腰痛在腰椎接受过“局部麻醉”，且其感觉减退源于此次“局部麻醉”。遗憾的是，我们无法得知16年前所采用的麻醉技术。采用25G Quincke针于L3 - 4椎间隙，在左侧卧位下注入2.0 ml 0.3%的高压丁卡因，顺利实施脊髓麻醉。患者一转为仰卧位，就开始抱怨其感觉减退节段区域出现严重的闪电样疼痛。4小时后，随着脊髓麻醉效果消失，严重的闪电样疼痛完全缓解。
