Liu Hsu-Tang, Yu Ya-Sheng, Liu Chen-Kun, Sung Chun-Sung, Chiou Hong-Jen, Tsou Mei-Yung, Tsai Shen-Kou
Department of Anesthesiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Acta Anaesthesiol Taiwan. 2005 Mar;43(1):49-53.
A 68-year-old female who underwent right ulnar nerve transposition surgery under axillary block (AB) by dual-technique (paresthesia and axillary artery penetration techniques) developed postoperative wristdrop. Physical examination showed local hematoma formation with ecchymosis at her right axillary region. Both ultrasonography and nerve conduction studies on her brachial plexus revealed neither direct hematoma compression, intraneural hematoma, nor peripheral neuropathy. Fortunately, she was completely restored to her right hand function 20 h after anesthesia, and was discharged without sequelae 17 days later. In this case, delayed recovery of radial nerve function after AB was suspected and the mechanism which led to this unusualness is discussed.
一名68岁女性在腋路阻滞(AB)下采用双重技术(异感法和腋动脉穿刺法)进行了右尺神经转位手术,术后出现垂腕。体格检查发现其右腋窝区域有局部血肿形成并伴有瘀斑。对其臂丛神经进行的超声检查和神经传导研究均未发现直接血肿压迫、神经内血肿或周围神经病变。幸运的是,她在麻醉后20小时右手功能完全恢复,并于17天后无后遗症出院。在本病例中,怀疑腋路阻滞后桡神经功能延迟恢复,并对导致这种异常情况的机制进行了讨论。