Hoftman Nir, Chan Karina
Department of Anesthesiology, David Geffen School of Medicine, UCLA, Ronald Reagan Medical Center, 757 Westwood Plaza, Mail Code 740330, Los Angeles, CA 90095-7403, USA.
Reg Anesth Pain Med. 2009 Jul-Aug;34(4):372-4. doi: 10.1097/AAP.0b013e3181ac7f74.
We describe 2 cases of Horner syndrome after epidural test dose injections in thoracic surgery patients. The Horner syndrome was transient and did not recur with full epidural activation and infusion.
Two patients undergoing thoracic surgery procedures received preoperative midthoracic epidural catheters for postoperative analgesia. Following the 3-mL 1.5% lidocaine test dose, a unilateral Horner syndrome was observed. No other signs and symptoms of high epidural blockade were seen, and the Horner syndrome subsequently resolved. After epidurogram confirmation of proper catheter position and at the conclusion of surgery, the epidural was activated with an appropriate bolus and infusion dose without recurrence of the Horner syndrome.
Two cases of Horner syndrome presenting after administration of an epidural test dose are reported. This uncommon initial finding could not be reproduced with subsequent epidural activation, perhaps suggesting that initial conditions within the epidural space had been altered. Successful utilization of neuraxial regional analgesia was achieved with careful postoperative monitoring of the patients.
我们描述了2例胸外科手术患者在硬膜外试验剂量注射后出现霍纳综合征的病例。霍纳综合征为一过性，在硬膜外完全激活和输注时未复发。
两名接受胸外科手术的患者在术前接受了胸段硬膜外导管置入以用于术后镇痛。在给予3毫升1.5%利多卡因试验剂量后，观察到单侧霍纳综合征。未出现其他高位硬膜外阻滞的体征和症状，随后霍纳综合征得到缓解。在通过硬膜外造影确认导管位置正确且手术结束后，以适当的推注量和输注量激活硬膜外，霍纳综合征未复发。
报告了2例在给予硬膜外试验剂量后出现霍纳综合征的病例。这一不常见的初始发现无法在随后的硬膜外激活时再现，这可能表明硬膜外间隙内的初始条件已发生改变。通过对患者进行仔细的术后监测，成功实现了神经轴区域镇痛的应用。
