Sakaguchi Y, Shinzawa M, Sakura S
Department of Anesthesia, Miyoshi General Hospital.
Masui. 2000 Oct;49(10):1136-8.
There is scant information in the literature regarding central neuraxial blockade in patients with previous back surgery or severe kyphoscoliosis. This report describes a 58-year-old female and an 84-year-old female with spinal instrumentation who presented for orthopedic surgery under neuraxial blockade. In both cases, multiple attempts of needle insertion using standard technique were unsuccessful, whereas spinal combined with epidural anesthesia was performed successfully using image intensifier. The anatomical considerations and difficulties in achieving reliable neuraxial blockade after spinal instrumentation are reviewed. Neuraxial blockade using image intensifier may provide less technical difficulty and a more reliable result in such patients.
关于既往有背部手术史或严重脊柱侧弯患者的中枢神经轴索阻滞，文献中资料匮乏。本报告描述了两名接受脊柱内固定的女性患者，分别为58岁和84岁，她们接受了在神经轴索阻滞下的骨科手术。在这两例患者中，采用标准技术多次尝试穿刺均未成功，而使用影像增强器成功实施了腰麻联合硬膜外麻醉。本文回顾了脊柱内固定术后实现可靠神经轴索阻滞的解剖学因素及困难。对于此类患者，使用影像增强器进行神经轴索阻滞可能技术难度较低且结果更可靠。
