Walter M, Rogalla P, Spies C, Kox W J, Volk T
Klinik für Anästhesiologie und operative Intensivmedizin, Charité-Universitätsmedizin Berlin, Campus Mitte.
Anaesthesist. 2005 Mar;54(3):215-9. doi: 10.1007/s00101-004-0792-z.
For perioperative anesthesia in a case of shoulder arthroscopy, a continuous interscalene plexus block according to Meier was performed in a 51-year-old female patient. The catheter was placed after stimulator-assisted punction and application of a local anesthetic. A few minutes after a further dose of local anesthetic was given via the catheter, the patient had to be intubated and ventilated with signs of total spinal anesthesia. The cervical CT showed the intrathecal displacement of the catheter, reaching the spinal canal near the root of the 7th spinal nerve. Blind advancement and deep placement increase the risk of an abnormal catheter position. Intraspinal misplacement should be reliably excluded.
在一例肩关节镜手术的围手术期麻醉中，对一名51岁女性患者实施了根据迈尔方法进行的连续肌间沟神经丛阻滞。在刺激器辅助穿刺并应用局部麻醉剂后放置导管。通过导管给予另一剂局部麻醉剂几分钟后，患者出现全脊髓麻醉体征，不得不进行插管和通气。颈椎CT显示导管鞘内移位，到达第7脊神经根附近的椎管。盲目推进和深部放置会增加导管位置异常的风险。应可靠排除椎管内误置情况。
