Shibata I, Shibata S
Division of Anesthesia, Kitakyusyu City Yahata Hospital, Kitakyusyu 805-8534.
Masui. 2001 Oct;50(10):1123-5.
A 70-year-old man who had undergone an elective transverse colectomy developed neural injury caused by defective epidural needle. The stylet of the 17-gauge disposable Tuohy needle used consisted of two components. The tip of the stylet was made of teflon and the material of the body was steel. The needle was inserted at Th 11-12, Th 10-11 and Th 9-10 interspaces utilizing the loss of resistance method with saline, but all the trials resulted in failure to identify needle entry into the epidural space. The patient complained of fatigue in his right lower extremity and the blood pressure was elevated to 235/125 mmHg during the series of the needle placement. The cause of the failure was finally found to be complete obstruction of the needle with a small piece torn from the stylet tip. Right femoral pain, right instep hypesthesia and muscle weakness in the right leg remained after the operation. These symptoms gradually improved and he left the hospital with slight hypesthesia remaining in his right instep 42 days after the operation.
一名70岁男性接受择期横结肠切除术后,因硬膜外穿刺针缺陷导致神经损伤。所使用的17号一次性Tuohy穿刺针的针芯由两部分组成。针芯尖端由聚四氟乙烯制成,主体材料为钢。采用生理盐水阻力消失法,分别在胸11 - 12、胸10 - 11和胸9 - 10椎间隙穿刺,但所有尝试均未能确定穿刺针进入硬膜外间隙。在一系列穿刺过程中,患者主诉右下肢乏力,血压升至235/125 mmHg。最终发现穿刺失败的原因是针芯尖端有一小片撕裂,导致针完全堵塞。术后患者仍有右股部疼痛、右足背感觉减退及右下肢肌肉无力。这些症状逐渐改善,术后42天出院时右足背仍有轻微感觉减退。