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椎管狭窄患者硬膜外麻醉后发生硬膜下脊髓血肿。

Subdural spinal haematoma after epidural anaesthesia in a patient with spinal canal stenosis.

作者信息

Chan M Y L, Lindsay D A

机构信息

Department of Anaesthesia, Austin Hospital, Heidelberg, Victoria, Australia.

出版信息

Anaesth Intensive Care. 2006 Apr;34(2):269-75. doi: 10.1177/0310057X0603400214.

Abstract

A 60-year-old male with a past history of T12 fracture had epidural analgesia for a radical prostatectomy. It was unknown prior to epidural insertion that the patient had a canal stenosis at T12 from the previous injury. The patient developed severe bilateral buttock pain after epidural catheter removal. Magnetic resonance imaging demonstrated a spinal subdural haematoma from T10 to L2 with mild cord compression. The patient made a successful recovery with conservative management. Neuraxial blockade should be approached with caution in patients with previous back injury, and only after a thorough assessment has been obtained to exclude spinal canal stenosis.

摘要

一名有T12骨折病史的60岁男性在根治性前列腺切除术中接受了硬膜外镇痛。在插入硬膜外导管之前,并不知晓该患者因既往损伤存在T12椎管狭窄。硬膜外导管拔除后,患者出现严重的双侧臀部疼痛。磁共振成像显示T10至L2水平存在脊髓硬膜下血肿,伴有轻度脊髓受压。经保守治疗,患者成功康复。对于有既往背部损伤的患者,应谨慎实施神经轴阻滞,且仅在进行全面评估以排除椎管狭窄后才可进行。

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