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剖宫产脊髓麻醉及术后疼痛采用患者自控硬膜外镇痛后发生椎旁脓肿。

A paraspinal abscess following spinal anaesthesia for caesarean section and patient-controlled epidural analgesia for postoperative pain.

作者信息

Huang Y Y, Zuo Z, Yuan H B, Tsou M Y, Chen M T, Tsai S K

机构信息

Department of Anesthesiology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.

出版信息

Int J Obstet Anesth. 2005 Jul;14(3):252-5. doi: 10.1016/j.ijoa.2005.03.001.

Abstract

We present a rare case in which a healthy parturient developed a paraspinal abscess after spinal anaesthesia for caesarean section and epidural analgesia for postoperative pain management. The catheter was in situ for 58 h. Backache was the initial and major symptom. A concealed course with no neurological deficit resulted in a delayed diagnosis and treatment in this case. The infection was not diagnosed until 20 days after the removal of the epidural catheter when there was a purulent discharge from the epidural puncture site. Surgical drainage was required. Anaesthesiologists should be aware that serious epidural analgesia-related infections can happen in extra spinal-epidural spaces. Vigilance for these infections, especially in postpartum patients with backache, is needed.

摘要

我们报告一例罕见病例,一名健康产妇在剖宫产术行脊髓麻醉及术后疼痛管理行硬膜外镇痛后发生椎旁脓肿。导管留置了58小时。背痛是最初的主要症状。该病例病程隐匿且无神经功能缺损,导致诊断和治疗延迟。直到硬膜外导管拔除20天后,硬膜外穿刺部位出现脓性分泌物时才诊断出感染。需要进行手术引流。麻醉医生应意识到,严重的硬膜外镇痛相关感染可发生在脊柱外硬膜外间隙。对于这些感染需要保持警惕,尤其是产后背痛的患者。

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